- The Washington Times - Sunday, August 6, 2006

NEW YORK (AP) — Pat Shelton has had the AIDS virus for at least 15 years and also struggles with hepatitis C and high blood pressure. But what is bothering her most on this sultry summer day are hot flashes.

“It’s kicking me,” Miss Shelton said. “But HIV, I’ve been very blessed. I don’t know why.”

The 53-year-old woman, whose drug regimen has kept her HIV from developing into full-blown AIDS, in many ways represents the changing face of the HIV population across the country: They are getting older and presenting new challenges to health care providers.

In New York City, 30 percent of the 100,000 people with HIV are older than 50, and 70 percent are older than 40, according to the city health department. Nationwide, 27 percent of people with AIDS are now older than 50, the Centers for Disease Control and Prevention reported.

“Here is a group of people who, yes, they have HIV, but they’re going to get other illnesses,” said Stephen Karpiak, the associate director of research for the AIDS Community Research Initiative of America. “And we don’t know the interaction of all the drugs. There are God knows how many hundreds of drugs used by folks for cardiac issues, osteoporosis, arthritis — we don’t know those interactions at all.”

The AIDS service organizations that arose after the epidemic hit in the 1980s were designed to provide care and counseling to people facing shortened life spans. While there’s still no cure for AIDS, anti-retroviral drugs have made it a manageable illness for many patients.

As this group ages, they fall prey to a host of conditions that require medicines that may interfere with the effectiveness of AIDS drugs.

And that’s if the condition gets diagnosed at all. AIDS patients typically see infectious disease specialists who may not have their antennae out for unrelated diseases, Mr. Karpiak said. They don’t look for age-related problems, he said.

Conversely, doctors unfamiliar with AIDS may not suspect that older patients have the disease.

Marjorie Hill of Gay Men’s Health Crisis, one of the nation’s largest AIDS service organizations, said 33 percent of the agency’s 15,000 clients are older than 50 — up from 25 percent two or three years ago.

Among the organization’s tailored services are meals and exercise classes better suited for older clients.

In addition, Miss Hill said, a public service campaign featuring older people — unlike the subway and magazine ads that typically show images of handsome young men — is in the works.

Miss Shelton, a former drug user who tested positive for HIV in 1991, has been an AIDS peer educator since 1998. She is trained to give support but gets support herself at Copacetic Women, a group for women older than 50 with HIV.

“I really don’t feel too comfortable sitting in a group with people my children’s age,” she said. “They’re not really going to open up or listen to what I really have to say. … We have concerns and health problems that the doctors are not taking care of. We needed a safe haven.”

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