Risks for Heterosexuals

About two years ago, Mary, a 65-year old woman began dating a former boyfriend. For most of the past 8 years, she has been celibate, but since she started seeing her former boyfriend again, she has had unprotected sex on numerous occasions. While she is aware of HIV and AIDS, she thought she had nothing to worry about since she knew the person with whom she was having sex. Recently, her sister told her that her boyfriend injects drugs and may not be entirely faithful to her, so she decided to get tested for HIV.

Jessie is a 58-year old widow who is very active and has had no health problems of any note. She enjoys an active social life and is eager to meet someone for a permanent relationship. Last year she went on a cruise. She met a man on the ship who was very attentive to her. Although she usually doesn't have sex with strangers, because of the romantic environment, Jessie had sexual intercourse with the man. She never saw him again after the cruise and thought perhaps she should get tested for HIV.

George, a 68-year old retiree lives on a limited income in public housing. He doesn't have a relationship with anyone special, but about once a month, when he gets his Social Security check, he has a sexual encounter with one of the young women who come to his housing complex to trade sex for money. He isn't consistent in using condoms. It depends on whether or not the woman insists. If the woman knows him, she will often have unprotected sex with him. A social worker suggested that George get tested for HIV.

The fastest increasing source of transmission for HIV among older adults is heterosexual contact. In 1998, the Centers for Disease Control (CDC) reported that 14.5% of adults over age 50 who were diagnosed with AIDS listed heterosexual contact as their only risk factor. This percentage was higher than among persons 13 to 49 years of age (12.7%).

Contrary to popular belief, several studies indicate that age does not inherently decrease sexual desire or activity. The National Council on Aging found that 61% of men over age 60 and 37% of women said they were sexually active. A study commissioned by the American Association of Retired Persons found that about half of those surveyed (between ages 45 and 59) have sex at least once a week.

Older women are becoming infected at a higher rate than older men. No longer concerned about pregnancy, the post-menopausal woman who is uninformed about the risk of HIV and other sexually transmitted diseases, may become more sexually active, have more partners and not use condoms. Furthermore, for an older woman, physiological changes may also increase her risk for infection. Post-menopausal decreases in vaginal lubrication and thinning of the vaginal walls may lead to mucosal lesions, which provide easier viral entry during intercourse.