Older women at risk of HIV often resist testing

NEW YORK (Reuters Health) - Older women who have a relatively high risk of being infected with HIV are often uninterested in being tested for the virus, new research suggests.

It's known that HIV testing rates are low among adults older than 50, even though health officials advise routine testing for everyone between the ages of 15 and 64.

In the new study, researchers found that women who had a moderate-to-high lifetime risk of HIV exposure often felt there was no need for it, the researchers report in the Journal of Women's Health.

The findings are concerning, they say, because older HIV-positive adults are often not tested until they develop obvious symptoms of a severely impaired immune system.

"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," lead study author Dr. Aletha Akers, of the University of Pittsburgh, explained in a statement. Greater efforts are needed for educating and testing older, high-risk women, according to Akers.

The study included 514 women age 50 or older living in the Atlanta area, three quarters of whom were African American. More than half were considered to be at moderate or high risk of having been exposed to HIV; risk factors included a history of IV drug use, having sex with a man with a history of IV drug use, or having a high lifetime number of sexual partners.

Despite this high level of risk, however, only one third of the women in the study said they'd ever been tested for HIV. And when asked, just 22 percent said they were interested in being tested.

"A third of all the women who were not interested in HIV testing reported lifetime risk factors for the disease," Akers said, "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."

Part of the problem may be a lack of advice from doctors, the study found. Less than one quarter of all of the women said a doctor had ever recommended they get an HIV test.

"We need to design prevention strategies and AIDS education for this vulnerable population," Akers said, "and help providers to incorporate HIV risk screening into the services offered to older women from high-prevalence communities."

SOURCE: Journal of Women's Health, July/August 2007.