Study author Dr. Aletha Akers, of the University of Pittsburgh School of Medicine, said that those tested for HIV have a tendency to do so late in the disease, when they are more likely to have obvious symptoms and progress more rapidly to AIDS and die within a year of HIV diagnosis.
"Older people largely have been overlooked in HIV prevention and testing programs, and consistently have lower HIV testing rates as compared with younger adults. Those who are tested tend to do so late in their disease, when they are more likely to have overt symptoms such as opportunistic infections. Often, they progress more rapidly to AIDS and die within a year of HIV diagnosis, which leaves little opportunity for treatment or secondary prevention for their partners," said Dr. Akers.
Akers and colleagues analyzed data from 514 women ranging in age from 50 to 95. The women visited a general internal medicine clinic at a large, inner-city hospital in Atlanta over a period of 11 months in 2001 and 2002.
To assess attitudes concerning lifetime HIV infection risk and interest in HIV testing, trained research assistants administered a 68-item questionnaire in a private room over the course of a single, face-to-face interview with study participants, most of whom said they were not currently sexually active.
The results showed that more than 60 percent of the participants had never been tested for HIV, although more than half of them could be described as moderate- to high-risk for HIV exposure. 22 percent of participants said they would be interested in HIV testing.
"Those who lacked interest were more likely to be older, African-American and not sexually active. These women had a low perceived risk, which was not always accurate based on their histories. A third of all the women who were not interested in HIV testing reported lifetime risk factors for the disease, but we found that they tended to point to 'those people' when talking about the danger of HIV rather than at themselves or their partners," said Dr. Akers.
To sum up, women with little HIV knowledge and low perceived personal risk were less interested in HIV testing, a finding that is at one with attitudes in much younger, high-risk adults, the study found.
"Yet, in part because of a lack of education and prevention efforts targeted at older populations, older women appear to be less capable of accurately assessing their lifetime risk of HIV even when they have significant risk factors and live in communities with high rates of infection. We need to design prevention strategies and AIDS education for this vulnerable population and help providers to incorporate HIV risk screening into the services offered to older women from high-prevalence communities," Dr. Akers said.
The findings of the study are published in the Journal of Women's Health.