HIV Infected Elderly Women: From Rhetoric to Reality—Experience from Eastern India

Abstract

Background: Detection of HIV among elderly is increasing globally and this is going to be a major public health issue in recent future. In India, data regarding demographical and clinical picture of HIV among elderly are sparse more so for elderly women. Elderly individuals especially women are still largely outside the light of HIV awareness programs and represent a major portion of undiagnosed HIV infected population with a poor quality of life. Methods and Materials: This cross-sectional study was conducted at HIV clinic of a tertiary care hospital in eastern India. 567 cases (men 457, women 110) that were detected to be HIV-positive at or after age of 50 years from 2008 to 2012 were analyzed on socio-demographical and clinical basis. Results: Detection of HIV was found to be increasing (5.7% in 2008 to 12.8% in 2012) among the elderly over last five years. Illiteracy (p < 0.01), unemployment (p < 0.001), seroconcordance of spouse (p = 0.02) and widowhood (p = 0.017) were seen more among elderly women. Frailty was the most common clinical presentation among elderly men (31%) whereas most of the elderly women were asymptomatic (27%) at the time of diagnosis. Mean CD4 count among HIV infected elderly men and women were 112 cells/dl and 137 cells/dl respectively at the time of diagnosis. Conclusions: HIV in elderly is an emerging entity in India and posing elderly women a worse socioeconomic burden despite a better clinical profile at the time of presentation. Clinicians, social workers and policymakers should come forward with wider awareness program targeted for elderly HIV patients especially women.