M2M Information Centre

We all wish to spend our senior years as happy and peaceful as possible.   Seniors desire and deserve good and compassionate health care, especially when the ability to take care of one’s self begins to diminish.   However, for many elderly LGBTQ citizens this is not the case.   Many gay men, lesbians and trans men and women find themselves forced back into the closet just to survive.  Elderly gay people living in nursing homes, assisted-living centres and even those receiving home care increasingly report being shunned, disrespected and mistreated by staff and fellow peers.  For a generation that was accustomed to being in the closet for most of their lives, the most common reaction is to retreat back to invisibility as a means of survival.   This retreating often leads to isolation and depression.   For those who have been out of the closet since Stonewall, being forced back into the closet can even lead to suicide.   Elderly heterosexuals suffer the indignities of old age as do elderly homosexuals, but not to the same extent.  As stated by Dr. Melinda Lantz, chief of geriatric psychiatry at Beth Israel Medical Center in New York City, “There is something special about having to hide this part of your identity at a time when your entire identity is threatened.  That’s a faster pathway to depression, failure to thrive and even premature death.” [1] 

There is a growing interest in the plight of aging LGBTQ citizens by gay men and lesbians concerned about their own futures.  Some development on LGBTQ friendly nursing homes and assisted living has been taking place in recent years, mostly in large urban centres.   The need of services for elderly LGBTQ will undoubtedly increase in the coming years as more of the post Stonewall generation enters into senior hood.    We as a community need to push for more responsive and culturally competent services and care for aging LGBTQ.  The AIDS Committee of Durham Region is in planning stage for a one day 'Senior Queer Citizen's - What Lies Ahead?' LGBTQ and Aging Conference for the fall of 2010.   The conference will be for healthcare providers as well as the LGBTQ community.  If you’re interested in this conference please email: M2M@aidsdurham.com.  We will all be seniors one day, so it’s in our best interest to be involved.  

HIV Prevention in adults over 50

Are older adults at risk of HIV infection?   The simple answer is yes.  While the Public Health Agency of Canada hasn’t separated infection rates for people over 49 in their most recent Surveillance Reports they have said that about 10% of HIV positive tests have been in people 50 and over since the HIV epidemic began in Canada.  This correlates with the Center of Disease Control surveillance reports in the US which show over 10% of all new AIDS cases in the US occur in people over the age of 50.  It is difficult to exactly determine HIV infection among older adults, as very few over 50 years of age routinely get tested.  Older adults are often first diagnosed with HIV at a late stage of infection, when they seek treatment for an HIV-related illness.

What is the leading cause(s) of risk among older M2M? 

“Men who have sex with men form the largest group of AIDS cases among adults over 50.  Older gay men tend to be invisible and ignored both in the gay community and in prevention.   Among the HIV risk factors for older M2M are internalized homophobia, denial of risk, alcohol and other substance use, and anonymous sexual encounters.”[2]  

There is few HIV prevention efforts aimed at people over 50.   Most HIV ad campaigns don't include older M2M, which creates an at-risk invisible population.   Older people are often less knowledgeable about HIV/AIDS and are less aware of ways to protect themselves from HIV infection.

People over 50 face other barriers to prevention than just a lack of HIV/AIDS awareness campaigns aimed at them.  “Doctors and nurses often do not consider HIV to be a risk for their older patients.  A study of doctors in Texas found that most doctors rarely or never asked patients older than 50 years questions about HIV/AIDS or discussed risk factor reduction.  Doctors were much more likely to rarely or never ask patients over 50 about HIV risk factors (40%) than they were to never or rarely ask patients under 30 (6.8%).”[3]  Contrary to myths and stereotypes, older adults are sexually active.  New medications for impotence and enhanced sexual pleasure may contribute to increased sexual activity.  Some older adults use substances like drugs and alcohol which can impair judgement and result in the individual partaking in activities that are of high risk for HIV infection.   Another barrier for older adults is that early symptoms of HIV mimic the processes of aging.  This also contributes to misdiagnosis.   A very common incorrect thought among older adults is that any blood test will detect HIV infection.  When blood is given for any reason, the belief is that the test is all-inclusive and will detect HIV.

Many older people live in assisted living communities, where there is still great stigma attached to HIV/AIDS, often associated with homosexuality and/or substance use.   Management can be resistant to providing HIV/AIDS educational materials or presentations in their facilities.

When well informed about HIV/AIDS, older adults can have a positive impact on prevention interventions with younger generations including their own children and grandchildren.  The AIDS Committee of Durham Region offers training and opportunities for older adults to volunteer their time, helping us to spread prevention education in the community.  

*The information on this page was in part taken from the following sources:

Center for AIDS Prevention Studies, AIDS Research Institute

Aging and Gay, and Facing Prejudice in Twilight – by Jane Gross NY Times

Seniors HIV Intervention Project - Broward County (Florida) Health Department

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