Why Are HIV Rates on the Rise Among Europe’s Older Adults?

New research published this week in the “Lancet” shows a sharp upward trend in HIV diagnosis rates among adults over 50 in Europe. What explains this alarming increases, and how can we reduce transmission risk?

Conducted by the European Centre for Disease Prevention and Control, the study examined the diagnoses rates of 31 European countries via their collected health data, exploring trends between the 2004 and 2015. The researchers also compared the trends by age, looking at HIV diagnosis rates among adults over 50 with those of 15- to 49-year-olds.

Researchers found that, during the monitoring period, HIV diagnoses rates were higher among the older adults, significantly increasing over time.

The highest increases occurred in Estonia, Latvia, Malta and Portugal, but the UK, Ireland and Germany also experienced significant increases. What’s more, while the rate of new diagnoses remained relatively steady among the 15 to 49 age group, there was a significant year-on-year increase of 2.1 percent for the older age group in 28 of the European nations.

While we know that certain communities — like men who have sex with men, or MSM – face stubborn HIV rates, these individuals were not the only ones impacted by this rise. HIV infection rates increased among MSM in both age groups during the 2004 to 2015 review, but the majority of the cases resulted from heterosexual sexual encounters. In younger people, rates went down, while they remained constant among the older group.

And while HIV cases related to intravenous drug use decreased among young people, they actually increased in the older group.

Furthermore, the research demonstrated that when HIV was diagnosed in the over 50 category, it was far more likely to reach an advanced stage in which it becomes harder to treat.

Researchers believe that a combination of apathy and a lack of HIV prevention programs targeting this age group may have led to gaps in early detection and monitoring which can increase HIV transmission and acquisition risk.

Study author Dr. Anastasia Pharris explains:
We often associate HIV with younger people who are sexually active, we assume sexually active means young people. These findings suggest that the HIV epidemic is evolving in new directions… In the last decade, the number of cases in older people has risen, whereas in younger people it’s staying stable.

It’s important to note that younger people still make up the majority of new infection cases overall, but health experts are increasingly concerned that society views sexual activity as solely for the young. As people live longer, they may remain sexually active well into old age, if not through their entire lives. And this is precisely the population that prevention programs seem to be missing.

Professor Janet Seeley from the London School of Hygiene and Tropical Medicine, adds:
The main thing is complacency, and also they are in relationships where pregnancy is not a problem, so contraception isn’t something people consider. I think there is very little publicity around HIV in Europe now that prevalence and incidence have gone down.

How Can Older People Cut Their HIV Risk?
Europe has seen a significant shortfall in spending for public services over the past decade as a result of the financial crisis and the resulting turn toward austerity. In the UK, for example, this has resulted in cutbacks across the health care sector — and often affects both elder care services and HIV prevention clinics.

Additionally, simple policy gaps mean older people aren’t often targeted by sexual health campaigns — and this must change. Health officials must also consider how Europe as a whole can accommodate refugees and migrants. These groups must be given access to health services as quickly possible to ensure they can protect their health as they begin to rebuild their lives.

All of these factors will require some financial investment, but if Europe is serious about meeting the goal of a HIV-free generation, must consider all demographics — not just the young — and tailor support to their particular needs.

by Steve Williams
Source – Care2