Heterosexual transmission and advanced stages of the disease are more common in adults aged 50 years and older who are newly diagnosed with HIV.
Patients aged 50 years and older newly diagnosed with HIV were more likely to report heterosexual transmission and more likely to be female than those younger than 50 years, according to an analysis of patients in New York State published in the journal JAIDS.
The findings “point to the need for improved physician education and discussion of sexual health issues with this adult population,” write Deepa T. Rajulu, M.D., and colleagues.
The study compared the characteristics of patients aged 50 years and older with patients younger than 50 years who were diagnosed with HIV and registered in the New York State HIV Registry through December 31, 2021. The researchers aimed to better understand the characteristics of aging HIV patients.
According to the study, between 2012 and 2021, the proportion of patients diagnosed with HIV aged 50 years and older ranged from 16% to 20%. Among the 2123 new HIV diagnoses in the country in 2021, 18% were among patients aged 50 and older.
Impact of heterosexual HIV transmission
The proportion of women diagnosed with HIV in 2021 was 32% among patients aged 50 years and older, compared to 15% among patients under 50 years.
“Although nearly 60% of people diagnosed with HIV under 50 years of age reported a risk of MSM [male-to-male sex] in 2021, this proportion was much lower (23%) in the 50 years and older age group,” the researchers write. “In addition, the percentage of people reporting a risk of HIV transmission through heterosexual contact or unknown risk was higher among people aged 50 years and older compared to the age group younger than 50 years.”
In particular, the risk of heterosexual transmission was 33% and the unknown risk was 39% in the older age group compared to 17% and 20%, respectively, in the younger group.
Among patients with new diagnoses in 2021, those aged 50 years and older were more likely to be diagnosed with stage 3 HIV infection: 36% compared to 17% in patients under 50. In the study, stage 3 HIV infection is defined as a diagnosis of AIDS made within 30 days of the initial HIV diagnosis.
“The higher incidence of stage 3 HIV diagnosis in people aged 50 years and older underscores the need for specialized HIV testing and treatment, treatment of co-morbidities, and social support for this population,” the researchers note.