The behaviors that increase the risk of contracting or transmitting HIV must be understood by the population in that preventative measures b undertaken. Gott reported that 65% of adults over the age of fifty received very little to no education about HIV and the percentage was similar for other sexually transmitted infections as well (2001). Similar data was collected from primary care physicians in 1997. Skeist and Keiser found that 61% of physicians rarely or never discussed HIV or AIDS with patients over the age of fifty. Nearly 68% of physicians rarely or never discussed reducing risk factors with older patients; and 40% reported rarely or never asking the patients over age fifty about potential risk factors for HIV. These findings were significantly different from discussions these same physicians reported as having with those patients under age the age of thirty. With the younger population, 93% of physicians reported discussing HIV risk behavior at least sometimes with the majority reporting having this important discussion regularly. From the data gathered in the study, the researcher was able to conclude that younger physicians believe older adults do not engage in behavior that can place one at risk for HIV and younger physicians are more uncomfortable discussing sexual behavior and intravenous drug use with the older adult patient (Skeist & Keiser, 1997). This belief is counter-productive for those adults over age fifty. A patient’s history must be considered in order to determine if the individual has ever engaged in behaviors where contracting HIV was a possibility as this virus may have gone unrecognized or undiagnosed for many years prior to a particular health visit. It is clear that primary care physicians must be made aware of the possibility of HIV and associated risk factors presenting in older adults.

The risk behaviors of the elderly are not well documented. One study done nearly 15 years ago by Stall and Catania found that there are elderly who engage in risky sexual behaviors with multiple partners of the same or opposite sex, are less likely than adults in their twenties to take preventative measures such as using condoms consistently, to receive treatment for intravenous drug use, and to refrain from sharing needles. Despite reported risky behaviors in the older adult population, many within this age group have never had a test for HIV (1994). The Center for Disease Control reports that based on a survey in 2007, less than 35% of adults ages forty-five to sixty-four and less than 15% of adults over sixty-five have ever been tested for HIV (Center for Disease Control and Prevention b, 2008). A study done in 1996 by Keitz and others showed that HIV testing outreach had been successful at reaching the population most susceptible to contracting the virus. However, the target population in this study was the younger adult. (Mueller, 1997). This same study recognized that a focus on targeting the young adult may account for some of the reasons that HIV has been diagnosed later and only after the disease has progressed in the older adult patient. This is problematic as HIV is therefore left untreated in the older adult population until the disease has changed to its more life-threatening, more difficult to treat, and more costly counterpart, Acquired Immunodeficiency Syndrome (AIDS). (Mueller, 1997) Outreach targeted toward the younger population almost exclusively, instead of the population as a whole, represents a flawed public health initiative.

Ongoing technological research has served to increase the life expectancy for Americans and more people are living longer and healthier lives. Advances in medicine have also served to increase the life expectancy for those infected with HIV or AIDS. The CDC concluded that 15% of all new diagnosis of HIV and 19% of AIDS diagnoses are related to people over the age of 50. (Center for Disease Control and Prevention a, 2008). Some factors that might contribute to older adults contracting HIV include: (1) Performance drugs such as Viagra and other male enhancement drugs have made it easier for older adults to continue sexual activity (Lieberman, 2000) (2) Internet dating has put divorcees back in the dating scene after many years of marriage and (3) Some older men and women are no longer concerned about pregnancy and in not perceiving themselves at risk, do not use condoms. (Crisologo, Campbell, & Forte, 1996)

The CDC estimated that at the end of 2006, there were 1.1 million people with diagnosed or undiagnosed HIV or AIDS (Center for Disease Control and Prevention c, 2008). HIV infected people over the age of fifty comprise an estimated 280,000 of the individuals (Center for Disease Control and Prevention c and e, 2008). Racial disparaties are more apparent among the over fifty population. There are twelve times as many blacks over the age of fifty infected with HIV as compared to Caucasians (Center for Disease Control and Prevention a, c, and e 2008).

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