Safer Sex and the Aged
HIV infection is viewed in a variety of manners. The population creates a kind of prototype or expectation about the nature of the persons that are at risk. Although some types of persons are more at risk for infection (persons engaged in anal sex, IV drug users that share needles), the reality is that anyone who is sexually active or using IV drugs has some level of risk. Groups of persons may not believe that the risk exists because of some type of assumption about the nature of the behavior or the “kinds” of persons that are involved. However, engaging in intravenous drug use and sexual intercourse provides an element of risk for all such individuals. The question of whether any particular group will accept that the behavior constitutes a risk remains an open question. The first step in effective methods of HIV education and prevention requires that a group accept that a risk exists for them. The recognition that elder Americans were not receiving attention was noticed more than a decade ago (Catania, Stall, Coates, Pehham, & Sacks, 1989; Catania, Turner, Kegeles, Stall, Pollack, & Coates, 1989). Although the recognition of the problem existed 10 years ago when about 10% of the HIV infections occurring in persons over the age of 50 (most of that to homosexual males), the problem gained little support in terms of federal spending or public attention (Shenson & Arno, 1989). For example, an examination of three books on issues dealing with social interaction (Derlega & Barbee, 1998), behavioral interventions (Kalichman, 1998), and the politics of AIDS (Elwood, 1999) contain no explicit and specific issues dealing with older persons at risk. Despite the potential size of and estimated size of the risk group, little attention has been targeted at the need for interventions and education for this population.
Probably no group is more unaware of the need to consider precautions for sexual behavior than the elderly. For the purposes of this chapter and clarity, we define this particular population as persons over the age of 50. For women, the more salient measure may be the onset of menopause, a physiological change. The reason that women may be considered different is that the lack of