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HIV Testing Overlooked for Older Population

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FSPH-led study finds few in the 50-64 age group are being screened, despite CDC recommendation.

HIV IS NOT OFTEN TALKED ABOUT as an issue for older U.S. adults, even as a growing number are living with the disease. People 55 and older now make up about 20 percent of the more than 1 million people living with HIV in the United States, and the 50-54 and 55-59 age groups each account for more diagnoses of HIV infection every year than the 15-19 age group.

And yet, according to Dr. Chandra Ford, associate professor in the Fielding School’s Department of Community Health Sciences, only about 5 percent of adults between the ages of 50 and 64 have been tested for HIV infection in the last year.

“It’s not like at age 50 sex stops, drug use stops, or anything else that carries the risk of HIV transmission stops,” Ford says. “So as more people in this age group areliving with HIV, the risk of infection and the need for HIV testing are likely to increase.”

Working with researchers from the U.S. Centers for Disease Control and Prevention (CDC), National Institutes of Health and UC San Diego, Ford served as the principal investigator of a study to determine the HIV testing trends of U.S. adults ages 50-64 both before and after 2006, when the CDC began recommending that doctors routinely screen all patients ages 13-64 for HIV unless they opt out. Ford and colleagues found that HIV testing among older adults increased initially following the recommendation, but never went above 5 percent and is now declining.

Ford suspects that many health care providers decide not to screen older adults because they judge them not to be at risk for HIV infection. “Following the CDC guide lines for people in these older age groups would be an efficient way to prevent HIV infections among people who tend to have other medical complications, or at least get infected people linked to care and treated early,” she says. “With more people accessing the health care system, not screening for HIV represents a missed opportunity.”