AIDS threatens elderly but stigma hinders treatment

Updated: 2011-12-01 21:58


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KUNMING- China has reported a soaring number of the elderly living with HIV/AIDS, but getting them treatment remains a thorny task for grassroots medical professionals as the stigma of the incurable epidemic lingers.

Figures revealed Wednesday by the Chinese Center for Disease Control and Prevention (CDC) show that the number of HIV-positive men in their 60s and above accounted for 8.9 percent of the country's total last year, while the group only took up 2.2 percent in 2005.

The surge in HIV infections among the elderly was mainly caused by elderly men's increasing involvement in sexual services, as their sexually active period has been prolonged due to improved living standards and health conditions, according to Wu Zunyou, director of the CDC HIV/AIDS prevention and control center.

"Some old men have adopted a more open attitude to sex than before, and nowadays, they have more access to commercial sex, especially cheap services," said Lu Lin, director of the CDC in the southwestern Yunnan province.

In addition, the increasing number of the HIV-positive elderly also resulted from the country's intensifying HIV testing efforts, Lu added.

Statistics from the CDC in Yunnan show that HIV-infected men in their 60s and above account for 8.3 percent of the province's total this year, 2.1 percent higher than 2010.

By the end of October, Yunnan reported 93,567 HIV carriers and AIDS patients, the most among all provinces, municipalities and autonomous regions.

Although it has become pressing for the government to tackle the growing prevalence of AIDS among the elderly, the stigma remains a major obstacle for such initiatives.

"Many old people living with HIV refuse to receive treatment. Some of them are retired government employees," said Kang Jun, head of the HIV/AIDS prevention and control office in Yunnan's Xishuangbanna Dai autonomous prefecture.

Their primary concern is that if they accept treatment, their situation will be made public, and they will therefore "lose face, " according to Kang.

Despite years of anti-discrimination campaigns in China, HIV/AIDS is still deemed as disgraceful by many people and patients themselves.

Influenced by the Confucian thoughts, Chinese culture places high value on an individual's reputation, especially the older generation, who are more tied to tradition.

Another justification for refusing treatment given by some HIV-infected elderly individuals is that "they are already old and don't have much time to live anyway," Kang said.

When trying to contact the HIV-positive elderly, the doctors were often rejected or even threatened, Kang said. "Many asked us to stop disturbing them. They would rather die and hold the secret forever." In some extreme cases, some said if their situation were exposed to others, they would choose to no longer live, according to Kang.

Most of the elderly were found to have contracted the virus when hospitalized for other diseases, he said."It's very difficult to persuade the elderly to do HIV testing voluntarily."

The only way to effectively prevent the further prevalence of AIDS among the elderly is to promote the use of condoms, said Lu Lin. "You can hardly keep all of them away from sexual services."

According to a survey conducted earlier this year in Yunnan, two thirds of the respondents, 158 HIV-positive men in their 50s who admitted to having paid for sex, never used a condom.

"Many old men intend to pay only 20 yuan ($3.20) and are unwilling to pay the extra expense of condoms," Kang said, adding that the elderly have become "prey" for low-end sex workers.

Groups of sex workers can be seen looking for potential clients in places where the elderly gather, such as parks and grocery markets, Kang said.

In the southwestern Chongqing municipality, where the HIV-infection rate for people in their 50s and above accounts for 17.2 percent of the city's total, local authorities have mobilized communities and training agencies to provide lectures about anti-AIDS knowledge and promote the use of condoms among the elderly, according to Wu Guohui, head of the AIDS prevention and control institute under the city's CDC.

China has 346,000 registered HIV carriers and AIDS patients, although the actual number is predicted to hit 780,000 by the end of 2011, according to the figure released by an expert panel consisting of members of China's Ministry of Health, the World Health Organization and UNAIDS.

The country has set the goal to reduce its HIV/AIDS infection rate by 25 percent by 2015 compared with that in 2010, with the fatality rate down 30 percent.

Thursday marks the 24th World AIDS Day, with the theme of "Getting to Zero," which means zero new HIV infections, zero discrimination and zero AIDS-related deaths.