HIV a growing problem among the elderly

PUBLISHED : Monday, 05 September, 2011, 12:00am
UPDATED : Monday, 05 September, 2011, 12:00am


A 64-year-old man says his wife scolded him and used him as a punching bag after he was diagnosed with HIV about three months ago. He's now been in a Shanghai hospital for two months and doesn't want to go home.

'I don't want to because the medical staff are kind to us patients and never show discrimination,' said the man who declined to reveal his full name. 'I think staying in the hospital is the hope held by all of us.'

His wife and daughter sent him to the Shanghai Public Health Clinical Centre in June but have never visited him there.

Aids, something Feng knew little about before, has been spreading more rapidly through the ranks of the mainland's elderly in the past few years, with experts saying that the main route of transmission is sex.

The percentage of those over 50 contracting HIV shot up from 7.8 per cent in 2006 to 14.9 per cent in 2009, according to an Aids prevention team from the Chinese Centre for Disease Control and Prevention (CDC). More than 60 per cent of new elderly HIV carriers were farmers, and 11 per cent city dwellers.

The team, from the CDC's National Centre for Aids/STD Control and Prevention, published their findings in the May edition of the Chinese Journal of Epidemiology. It showed that nearly 70 per cent of elderly people contracting HIV were infected through heterosexual transmission, up from 38 per cent, while the homosexual infection rate rose from 0.7 per cent to 3 per cent. Three-quarters of heterosexual cases were contracted through extramarital sex.

The 64-year-old said his retirement was relaxed but boring. He began frequenting prostitutes at foot massage centres without any idea about the need to practise safe sex.

'They are so cheap - less than 100 yuan (HK$121) a time - and I thought it was a good deal,' he said.

After developing a cyst and fever in May, he spent three weeks seeing doctors at four Grade-A hospitals in Shanghai. Finally, another doctor told him to get tested for HIV.

After being told he was HIV-positive, he said it felt like the sky blackened and the land shook. Outside the hospital, he squatted by the road, crying for an hour, before walking home, taking four hours to complete a journey that normally took him one at most.

'I wasn't thinking about death,' he said. 'What I was concerned about was how I could tell my family? How could I open my mouth?'

His wife raged and scolded him heavily in the days that followed. But he said he decided to put up with her bad temper because he was in the wrong.

Dr Lu Hongzhou , vice-president of the Shanghai Public Health Clinical Centre and a leading Aids expert on the mainland, said many elderly male patients, with open but ignorant attitudes towards sex, had similar experiences.

The CDC's study said the improved quality of life and longer average life spans in recent decades meant that mainland senior citizens enjoyed better health and better sex lives, with men in particular remaining sexually active for longer.

'The sexual demand from these old men is usually overlooked by their families and the whole society,' the study said. 'Therefore unsafe sex activities occur, such as in visiting prostitutes and developing homosexual relations.

'Old people commonly embrace a mindset of fearing nothing and caring nothing; they tend to have unprotected sex, leaving huge problems in controlling the spread of HIV.'

Lu said many old men refused to wear condoms because they were worried that their sexual performance might be adversely affected. Most of the women contracting the disease were infected by their husbands, who had hired prostitutes.

The CDC study said the five mainland provinces and regions with the most HIV patients over the age of 50 were Guangxi , Henan , Yunnan , Guangdong and Sichuan . A survey by the Guangxi health department found that the disease had spread from 'high-risk' groups - prostitutes and injecting drug addicts - to ordinary people, with more farmers over the age of 70 becoming infected, according to report.

Li Lin, head of the Aids Care China organisation in Guangxi, said many elderly farmers encountered prostitutes at rural fairs. His organisation provides help for two thirds of the more than 12,000 infected people in the autonomous region.

'These xiaojie (an informal term for prostitutes on the mainland) are actually housewives about 40 to 50 years old, and they work as prostitutes temporarily to increase their family's incomes,' Li said. 'They are illiterate and have no idea of safe sex. It's hard to identify this group of people, who are essential in Aids prevention and control in rural regions.'

He said some elderly patients were not confident about receiving treatment and even gave up. 'They said there was no difference between being cured and not being cured since they had already lived a long life,' he said.

Lu said another problem in treating the elderly was that there were far more prominent toxic side effects from anti-viral drugs in old people due to organ malfunctions.

He said safe sex education for the elderly remained a blind spot in the authorities' efforts to combat the spread of HIV.

The 64-year-old regretted his promiscuity but added that it was meaningless since 'there is no drug to cure remorse'. He will be released from hospital soon but is still weighing up whether to claim reimbursement for his medical bills from his former employer, a state-owned enterprise.

'Staying here for two months has cost me over 5,000 yuan. Turning to my former employer means my situation will be known to everyone and a pervasive social stigma will no doubt follow. I am really embarrassed now.'