America is growing older, and so is its population of HIV-positive adults. This year, for the first time ever, half of Americans living with HIV are 50 years old and older. For many of them, like Michael Hawkins of New Britain, Connecticut, life presents a unique set of challenges, including increased social isolation. I visited Hawkins recently to learn how he's been coping with HIV.
In the kitchen of his cramped third-floor apartment, Hawkins removed the cap of a prescription bottle containing dozens of large tablets of an antiviral medication called Atripla. Placing a pill into his cupped palm, he said a single daily dose is all he needs now to keep his HIV at bay.
Hawkins was in his late twenties when he found out he had HIV. It was 1987, and he was a young husband with two kids and an affinity for intravenous drugs. He said that’s how he became infected.
Michael Hawkins considers himself one of the lucky ones, but he's seen the impact isolation can have on the aging community.
Today, Hawkins is 56. He has 13 grandchildren and is showing little wear from his infection. In recent years, he said he’s found his calling as an HIV advocate, and joins some 600,000 older Americans living with the virus.
Advancements in antiretroviral therapy mean that, for many, HIV is no longer a death sentence. But there’s also another trend going on in the number of new infections impacting the aging population. Adults over age 50 account for approximately 11 percent of all new HIV infections in the United States.
Stephen Karpiak is the senior director for research at the AIDS Community Research Initiative of America. He said many aging patients aren't hearing about things like drugs and safe sex from their healthcare professionals.
"Largely, older adults do not see themselves at risk for HIV. And part of that perception is the fact that their care providers, their medical care providers, don’t see that as well," said Karpiak. "You know, they’re sitting there with their physician, or nurse practitioner, or whatever who are older and, in some respects, the same age as the patient, and yet they don’t see the patient as being a sexual being, as having sexual activity."
According to Karpiak, older adults still engage in risky behaviors like sex and drug use, and lack of awareness only puts them in danger of contracting the virus or having an existing infection go untreated.
But the problem extends beyond health care. Persistent stigma and misinformation about HIV mean that many older adults are also not getting a lot of the social and emotional support they need.
Back in the '80s and early '90s, volunteer-based services known as buddy programs provided members of the HIV community with close social networks. But they were founded with the idea that most infected adults would never make it past retirement age.
Terri Clark is the Prevention Services Coordinator at ActionAIDS in Philadelphia. It’s home to one of the few buddy programs left in the country. She said once people with HIV began living longer, many of these supports began to disappear.
"Now, the folks who are into their 60s and beyond, many of the friends or family members they had back 20 to 30 years ago are all gone," said Clark. "So, where, where do you rely on for support?"
Clark said inadequate access to social supports often leads to feelings of isolation in older adults. Michael Hawkins considers himself one of the lucky ones, but he’s seen the impact isolation can have on the aging community.
"They don’t get the right care or take care of themselves, or they throw in the towel," said Hawkins. "And then the depression comes in."
By 2020, it’s estimated that 70 percent of all Americans living with HIV will be older adults. Hawkins said he wants to see states doing more to improve HIV aging services in the coming months and years.
Aundrea Murray contributed to this report.
