Knowledge and attitudes about sexuality in the elderly with HIV/AIDS <span class="so-article-trans-title" dir="auto"> Translated title: Conocimiento y actitudes sobre sexualidad en ancianos portadores de VIH/SIDA </span> <span class="so-article-trans-title" dir="auto"> Translated title: Conhecimento e atitudes sobre sexualidade em idosos portadores de HIV/AIDS </span>

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Abstract

OBJECTIVES: Assess the knowledge and attitudes about sexuality in the elderly with HIV/AIDS served in a specialized ambulatory clinic; and identify the epidemiological profile of these patients. METHODS: Cross-sectional, descriptive and analytical study with a sample of 148 people aged 50 years and over. The Aging Sexual Knowledge and Attitudes Scale was used to assess the knowledge and the attitudes about sexuality of the elderly. RESULTS: The study included 148 elderly, male gender (63.5%), single (30.5%), retired and pensioners (53%), low socioeconomic class (60%), only 21% have completed the Secondary Education, monthly family income 3.3 minimum wages, time since diagnosis 156 months and predominant form of infection via sexual (66.2%). ASKAS knowledge score was 32.2 and attitudes score was 15.5. There was significant association between the knowledge ASKAS with the female gender, being a widow and more than one comorbidity; and between the attitudes ASKAS with complete Secondary Education and physical activity. CONCLUSION: Patients with HIV/AIDS showed favorable knowledge and attitudes about sexuality in the elderly, and women that were housewives showed significant knowledge.

Translated abstract

OBJETIVOS: Evaluar el conocimiento y actitudes sobre sexualidad en ancianos con VIH/SIDA atendidos en Consultorio Externo especializado; e Identificar el perfil epidemiológico de esos pacientes. MÉTODOS: Estudio de corte transversal, descriptivo y analítico realizad con una muestra de 148 personas con 50 años o más. Se utilizó la Aging Sexual Knowledge and Attitudes Scale para evaluar el conocimiento y actitudes sobre la sexualidad de los ancianos. RESULTADOS: Participaron en el estudio 148 ancianos, sexo masculino (63,5%), solteros (30,5%), jubilados y cesantes (53%), clase económica baja (60%), solamente 21% poseían hasta primaria completa, ingreso familiar mensual 3,3 salarios, tiempo de diagnóstico 156 meses y forma de contagio predominante vía sexual (66,2%). Score de la ASKAS de conocimiento fue de 32,2 y de actitudes 15,5. Hubo asociación significativa entre ASKAS conocimiento y género femenino, ser viudo y más de una comorbilidad y ASKAS actitudes con primaria completa y actividad física. CONCLUSIÓN: Pacientes con VIH/SIDA demostraron conocimiento y actitudes favorables sobre la sexualidad en el anciano, y mujeres amas de casa presentaron conocimiento significativo.

Translated abstract

OBJETIVOS: Avaliar o conhecimento e atitudes sobre sexualidade em idosos com HIV/AIDS atendidos em ambulatório especializado; e Identificar o perfil epidemiológico desses pacientes. MÉTODOS: Estudo de corte transversal, descritivo e analítico com amostra de 148 pessoas com 50 anos ou mais. Utilizou-se a Aging Sexual Knowledge and Attitudes Scale para avaliar o conhecimento e atitudes sobre a sexualidade dos idosos. RESULTADOS: Participaram do estudo 148 idosos, sexo masculino (63,5%), solteiro (30,5%), aposentados e pensionistas (53%), classe econômica baixa (60%), somente 21% possuíam até ensino médio completo, renda familiar mensal 3,3 salários, tempo de diagnóstico 156 meses e forma de contágio predominante via sexual (66,2%). Escore da ASKAS de conhecimento foi 32,2 e de atitudes 15,5. Houve associação significante entre ASKAS conhecimento e gênero feminino, ser viúvo e mais de uma comorbidade e ASKAS atitudes com ensino médio completo e atividade física. CONCLUSÃO: Pacientes com HIV/AIDS demonstraram conhecimento e atitudes favoráveis sobre a sexualidade no idoso, e mulheres donas de casa apresentaram conhecimento significante.

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Estimated HIV Incidence in the United States, 2006–2009

Joseph Prejean, Ruiguang Song, Ángela Hernández … (2011)

Background The estimated number of new HIV infections in the United States reflects the leading edge of the epidemic. Previously, CDC estimated HIV incidence in the United States in 2006 as 56,300 (95% CI: 48,200–64,500). We updated the 2006 estimate and calculated incidence for 2007–2009 using improved methodology. Methodology We estimated incidence using incidence surveillance data from 16 states and 2 cities and a modification of our previously described stratified extrapolation method based on a sample survey approach with multiple imputation, stratification, and extrapolation to account for missing data and heterogeneity of HIV testing behavior among population groups. Principal Findings Estimated HIV incidence among persons aged 13 years and older was 48,600 (95% CI: 42,400–54,700) in 2006, 56,000 (95% CI: 49,100–62,900) in 2007, 47,800 (95% CI: 41,800–53,800) in 2008 and 48,100 (95% CI: 42,200–54,000) in 2009. From 2006 to 2009 incidence did not change significantly overall or among specific race/ethnicity or risk groups. However, there was a 21% (95% CI:1.9%–39.8%; p = 0.017) increase in incidence for people aged 13–29 years, driven by a 34% (95% CI: 8.4%–60.4%) increase in young men who have sex with men (MSM). There was a 48% increase among young black/African American MSM (12.3%–83.0%; p<0.001). Among people aged 13–29, only MSM experienced significant increases in incidence, and among 13–29 year-old MSM, incidence increased significantly among young, black/African American MSM. In 2009, MSM accounted for 61% of new infections, heterosexual contact 27%, injection drug use (IDU) 9%, and MSM/IDU 3%. Conclusions/Significance Overall, HIV incidence in the United States was relatively stable 2006–2009; however, among young MSM, particularly black/African American MSM, incidence increased. HIV continues to be a major public health burden, disproportionately affecting several populations in the United States, especially MSM and racial and ethnic minorities. Expanded, improved, and targeted prevention is necessary to reduce HIV incidence.

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HIV infection, inflammation, immunosenescence, and aging.

Steven Deeks (2011)

Although antiretroviral therapy for HIV infection prevents AIDS-related complications and prolongs life, it does not fully restore health. Long-term treated patients remain at higher than expected risk for a number of complications typically associated with aging, including cardiovascular disease, cancer, osteoporosis, and other end-organ diseases. The potential effect of HIV on health is perhaps most clearly exhibited by a number of immunologic abnormalities that persist despite effective suppression of HIV replication. These changes are consistent with some of the changes to the adaptive immune system that are seen in the very old ("immunosenescence") and that are likely related in part to persistent inflammation. HIV-associated inflammation and immunosenescence have been implicated as causally related to the premature onset of other end-organ diseases. Novel therapeutic strategies aimed at preventing or reversing these immunologic defects may be necessary if HIV-infected patients are to achieve normal life span.