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Including the elderly in the conversation

Michael David C. Tan notes the continuing non-inclusion of the elder population in HIV-related discussions in the Philippines, even if overseas, the link between HIV and aging is being given focus. This neglect “should be both a source of concern, and a source of shame for HIV activists in the Philippines,” he says.

THE AUTHOR AT THE ACRIA GATHERING ON HIV AND AGING IN NEW YORK CITY PHOTO COURTESY OF VALOULOU FRANCOIS JACQUES, CEO, MEDPlus

This is part of the author’s LGBTQIA encounters in New York City (and beyond), where he works as a State Department Fellow/Community Solutions Leader of the Community Solutions Program (CSP), a program of the Bureau of Educational and Cultural Affairs of the United States Department of State, and implemented by IREX.

Basta bata ang ka-sex para siguradong malinis (As long as you have sex with a young man to be sure he’s clean). Of course, huwag magpaputok sa loob (be sure he doesn’t orgasm/cum inside you).”

Those were the words of Mother Leony, who was interviewed by myself with Raine N. Cortes and John Ryan N. Mendoza in 2010.

And the words came back to me again after speaking with HIV activists in the US, where – at least; and finally, if I may say so – emphasis is being provided on HIV and aging.

This issue is worth highlighting, according to ACRIA (AIDS Community Research Initiative of America) Center on HIV & Aging, because of the “unique needs and challenges that older adults of diverse populations living with HIV face as they age”. There are hard facts worth highlighting – e.g. by 2015 (that’s already next year, by the way!), half of all people living with HIV (PLHIV) in the US will be aged 50 and over; and by 2020, thanks to the medical advances (including better antiretroviral treatments), the figure rises to 70%.

Aging, by itself, brings with it unique challenges (e.g. menopause/andropause, cardiovascular disease, dementia, osteoporosis, et cetera). But coupled with being HIV-positive, the challenges increase (e.g. multiple health concerns because of aging AND because of being HIV-positive, high levels of isolation, impact of HIV and ageism, et cetera).

ACRIA has actually been “tooting the horn” – in a manner of speaking – since 2006, when it released a report (Research on Older Adults with HIV or ROAH) that highlighted the link between HIV and aging. Even then, in New York City, considered as the “HIV epicenter of the US”, 30% of the almost 100,000 PLHIV are over 50, and 70% are over 40. And while this pattern is seen throughout the US, “few have internalized this fact: there will soon be large numbers of senior citizens living with HIV.”

According to Mark Milano, publications manager and treatment educator of ACRIA, “the epidemic is aging.” This is because, as more people get treatment, there’s going to be a significant number of PLHIVs who will be aging. And the issues you deal with as a young adult are quite different from the issues of the older adult. As such, even if governments are not paying as much attention as they should now, they will eventually change.

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“They’re going to have to pay attention. As more people get treatment, they’re going to live longer,” Milano said.

Cathy Renna, senior vice president of Target Cue, agrees. “We barely talk about older people, especially older LGBT people… so this kind of advocacy is important, that there are affected populations than the ones we see the most.”

Meanwhile, ACRIA’s Cesar Angel noted that “there’s so much we still don’t know about aging and HIV, so we’re still learning about it.”

Back in the Philippines, the face of HIV continues to be young. The Philippine HIV/AIDS Registry (sic), for instance, reported in July that the median age range of those who were infected through sexual transmission was 28 years. A month earlier, in June, the registry reported that 58% of the new cases involved Filipinos in the 20-29 age group.

Not surprisingly, I suppose, the existing efforts in the Philippines focus on the young – both in prevention (e.g. the efforts of Quezon City Health Department); and even in treatment, care and support (TCS) (e.g. not a single program exists for the elderly). So much so that the likes of, say, Shola Luna are lumped with others, even if there may be special needs that need to be answered (and we’re not even talking about the needs of transgender PLHIVs yet).

We need to look into this. Sooner, rather than later. Otherwise, we won’t be ready – again – when it blows in our faces (much like the issue on the ARV stockout, only worse).

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But – back to Mother Leony and others like him – the issue for us in the Philippines has to do with our non-inclusion of them, in the first place, even in prevention efforts (as noted earlier). And that elder members of the LGBTQIA community who are just as at risk for HIV infection are not at all included in existing programs should be both a source of concern, and a source of shame for HIV activists in the Philippines.

And this shouldn’t have to be like this.

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