Age is no defense against AIDS. Women aged 50 and older are living longer and remain sexually active, yet many lack appropriate knowledge about HIV transmission and prevention, according to recent findings published in the Journal of the American Geriatrics Society. The findings are based on a questionnaire that surveyed 514 women aged 50 and older in the general medical clinics at Grady Memorial Hospital in Atlanta.
Of the nine questions assessing older women's knowledge of risk of HIV sexual transmission, the mean knowledge score was 3.7, with no respondent correctly answering all nine questions. This poor performance suggests that active measures must be taken to increase older women's knowledge about HIV.
Participants also identified all sources from which they received HIV information. Eighty-five percent of those surveyed indicated they received their information from television; another 54 percent said they learned about HIV from friends; and 51 percent identified newspapers as their information source. Only 38 percent said they ever received information about HIV from their healthcare providers.
Lisa Bernstein, MD, assistant professor of medicine in the Emory University School of Medicine's Division of General Medicine at Grady Hospital, served as principal investigator, and is one of the study's leading authors.
"The misconception is that older people don't have sex anymore, and that they really are not engaging in risky activity," Dr. Bernstein says. "As part of older women being at risk for HIV, much of it is based on how much they know about HIV. Unfortunately, this population has not been targeted with HIV prevention messages because they aren't considered to be at risk. Yet their risk is probably rooted partially in their low knowledge."
According to the article, 10 percent of AIDS cases in adult women in the United States have occurred in those aged 50 and older; the majority of these cases resulting from sexual transmission. The article also notes that 32 percent of these women were aged 60 and older at diagnosis, "suggesting that their infections occurred in the postmenopausal years."
The article also notes that older adults do not know as much about HIV transmission and prevention as their younger counterparts. The authors indicate that in the National Health Interview Study (NHIS), for example, people aged 50 and older scored lower on knowledge questions about HIV/AIDS than younger adults. The most pronounced deficits involved the efficacy of condoms in preventing HIV transmission.
"The important thing to realize is that these patients are still sexually active," Dr. Bernstein says. "The problem is that they don't realize that they're at risk for this life-threatening disease. By trying to improve their knowledge and impart the fact that physicians have a tremendous role to play in educating patients - even those who are older than we normally think to be at risk - we can really make great strides to protect them against this disease."
As part of the study, data were collected between June 2001 and July 2002 in face-to-face interviews. Women were asked nine questions to assess their knowledge of HIV sexual transmission and prevention. Questions involved such topics as heterosexual intercourse; kissing; oral sex; abstinence; condom use; spermicide; diaphragm; vasectomy; and monogamy.
The majority of women (65 percent) scored poorly, answering four or fewer questions correctly. Eighty-four percent of women correctly identified unprotected heterosexual sex as a moderate-to-high-risk activity; 63 percent of women incorrectly identified kissing as a mode of transmission; 76 percent overestimated oral sex as a mode of HIV transmission; and only 13 percent identified condoms as effective in preventing HIV, while 18 percent said they were not effective at all. Forty-four percent of the women said abstinence was not at all or somewhat effective.