Older Women & HIV

HIV infections are on the rise. According to the Center for Disease Control and Prevention (CDC), the number of Americans over 50 who are infected with HIV have grown over 5 times (16,300 people in 1995, to 90,600 in 2003). While seniors represent about 14% of people with HIV, senior women represent 18%. The numbers of women with infections are even higher for American women of color, and come in at a staggering 47% when looking at world HIV infection rates. That means that just under half of all HIV infections are found in women worldwide.

One reason for the higher number of older women with HIV was found in a study recently published by Emory University. They surveyed 514 women over the age of 50, and found that their knowledge about transmission was poor. For example, approximately 50% of women believed that vasectomies and diaphragms prevent the spread of HIV.

Other reasons include the fact that many older women, who have sex with men, are also not using condoms, knowing they are past the point of having to worry about pregnancy. Women also erroneously think they can’t get HIV if they are not engaging in behaviors they deem as risky. The truth of the matter is this. HIV is a virus. It’s an opportunist. It does not care if you are male or female. It does not care who you have sex with, nor the numbers of people you have sex with. It certainly does not care about the color of your skin, you bank balance or you age.

HIV is primarily spread in two ways. First is though the sharing of contaminated intravenous drug equipment. Second, and more commonly, HIV is spread by unprotected sexual encounters. Women frequently are the receptive partners, and the receptive partners are more likely to become infected. Women who are post menopausal are at higher risk because of the changes in the vaginal tissue. With less estrogen to nourish the vagina, the tissue atrophies (becomes thin) and there is less lubrication. A woman can easily get tiny tears in her vaginal tissues, thus leaving an opening for virus to gain entry to her blood stream.

What’s a woman to do?

1. Know your own HIV status. Contact your health care provider, or (if you want anonymous testing) the local health department for testing. I do not recommend home testing at this time. First, if you are positive, are you really? And if you are negative, are you really? If positive, confirmatory blood testing is required. Many offices have started using rapid testing in the office where preliminary results can be obtained in 20 minutes. In the meantime you can get the appropriate information on how you need to proceed.
2. Know your partners history (this goes for both male AND female partners ladies!). Do they have a history of multiple partners and unprotected sexual encounters? Have they been tested? When? Did they get a follow up test at 6 months? What were the results?
3. Condoms and lubrication are essential. Use them not only on your partners body parts that may be entering you, but also on any toys you may be utilizing as well There are several online and confidential sources to purchase lubricants, condoms and gloves.
4. Limit your exposure when possible. Think twice if you are engaging in high risk behavior with a casual or new partner.
5. Educate yourself. The information presented here is just a small portion of what you need to know. Each of us bears the responsibility to educate ourselves and our partners.

For many women, sexual activity does not stop just because they reach a certain age. I encourage you to continue to enjoy yourselves, but do so safely.

For over 26 years, Barbara C. Phillips, MN, NP has been involved in health care. Now, as the founder of OlderWiserWomen, LLC, that experience and passion is focused on Women who want to experience the freedom, magic and wisdom of successful aging.

What You Need to Know About HIV and AIDS

When the first known case of Acquired Immune Deficiency Syndrome (AIDS) was recognized in New York and Los Angeles in June 5, 1981, the world's attention was immediately caught and people almost put a sudden halt in their sexual activities. A great confusion followed in regards to the relationship of AIDS to Human Immunodeficiency Virus. Is AIDS caused by HIV or the other way around? Does the existence of AIDS in one person automatically translate to the existence of AIDS in another? Along with the great confusion came a heightened stigma and prejudice against homosexual men who were believed to be the first to have contacted the disease.

AIDS is the conglomeration of symptoms and infections in humans as an outcome of being infected with the human immunodeficiency virus (HIV), which causes specific and irreversible damages to the immune system. Ironically though, AIDS was first to be discovered before HIV. It was only in 1983, two years after the historic 1981 AIDS cases were recorded, that the Human Immunodeficiency Virus was discovered. It was at the Pasteur Institute in France that scientists, led by Luc Montagnier, discovered the cause of AIDS--HIV. It was not even labeled HIV then. The first name for it was lymphadenopathy-associated virus (LAV). A year later, Americans confirmed the discovery of the virus but re-named it as T lymphotropic virus type III (HTLV-III). This then created some political stir between France and the United States government. The conflict was eventually settled when President Mitterrand of France and President Reagan of the USA finally agreed to call it by one name in 1986-- HIV. There are two known species of the HIV Virus, the HIV-1 and HIV-2. Both are believed by scientists to have come from West Africa.

However, studies have confirmed that HIV infection comes first before AIDS. HIV is a retrovirus; it belongs to the viral family Retroviridae. Viruses in this family are enveloped viruses possessing an RNA genome and replicate via a DNA intermediate. A dramatic reduction in the vitality of the human immune system is the primary result of an infection of HIV. It directly and indirectly destroys marcophages, dendric cells, and CD4+ T cells of the body. These elements are very essential in the proper functioning of the human immune system. Once the immune system is attacked by HIV, various infections and diseases start to manifest; the collection of these diseases is what we call AIDS. The most common diseases caused by HIV are acute renal failure, cardiomyopathy, dementia, and encephalopathy. HIV also attack the brain, heart, and kidney. Many of the problems faced by people infected with HIV result from the failure of the immune system to protect the body from opportunistic infections and cancers.

What immediately follows after an exposure to sources of HIV is the development of acute infections. The stage of acute infections or primary infections is the period when the virus replicates inside the body and causes flu-like infections such as fever, malaise, myalgia, pharyngitis, lymphadenopathy, and fever. Since flu-like infections such as these are very common among people with flu, these symptoms of a possible HIV infection are mostly being dismissed as mere cases of flu. In most cases, the infection is only realized to be an HIV infection if the case has already turned into an AIDS disease. The second stage of HIV infection is the chronic asymptomatic infection stage. This stage is chararcterized by a long duration of infection, an average of 8 to 10 years, without symptoms. Infections on this stage range from unexplained chronic diarrhea, persistent fever, severe weight loss, oral hairy leukoplakia, candidiasis, and severe bacterial infections including pulmonary tuberculosis. It is at stage two that the body's CD4+ T Cells count starts to drop below the 500 count. When the CD4+ T Cells count reaches below 200 count, the HIV infection then leads to AIDS.

Very rare cancer cases, neurological complications, and drastic malnutrition are the general symptoms of AIDS. Further, acquiring AIDS leads to more harmful diseases like common bacterial infections (Toxoplasmosis, Progressive multifocal leukoencephalopathy, Escherichia coli, Listeria, Campylobacter, Salmonella, and Shigella), Kaposi's sarcoma (cancer of the blood vessel), Pneumocystis jiroveci pneumonia (caused by yeast-like fungal infection), and dementia complex.

The ways through which humans can have an HIV infection are the same as the way they can get AIDS. Among the most common modes of transmission are unprotected sexual contact (vaginal, oral, and anal contacts) with an HIV-infected person, blood or blood product route, and pregnant women instances or mother-to-child transmission. The means to avoid being infected also go the same for both HIV and AIDS. To avoid infection through sexual contact, abstinence or the use of condom, to avoid exposure to infected bodily fluids, are most advised by many doctors. On the other hand, needles should never be shared to prevent HIV or AIDS transmission through blood product routes.

It is good for people to know that HIV or AIDS is not an airborne disease nor is it transmissible by mere physical contact to avoid *paranoia cases* and unfounded judgments towards others. Currently, HIV is a disease that can be treated but not cured. Anti-retroviral agents, which are not accessible to most people with HIV, can only go as far as reducing the complications but cannot totally eradicate the presence of HIV. As of now, no vaccine has yet been developed to prevent the transmission of HIV, more so the deadly existence of AIDS.

Treatment Interruption: Most Patients Could Not Maintain Immune Control

A leading research group on HIV treatment interruption reported that very early antiretroviral treatment with supervised interruptions did not enable most patients to develop enough immune control to stop antiretrovirals permanently. While 11 of 14 patients were able to remain off treatment for as long as 90 days (with viral load under 5,000, an arbitrary level based on the treatment guidelines in use when the study started), only 3 of the 14 could stay off treatment entirely for as long as two years. Seemingly good HIV-specific immune responses were found, but often they were not protective. It is not known if the viral setpoint was lowered in these patients by this early treatment protocol. This research update appeared in the December 2004 issue of PLOS Medicine (a new online journal published by the Public Library of Science), where it is freely available to anyone.1
Treatment interruption in order to establish immune control should not be confused with other kinds of treatment interruptions, such as the five-days-on-two-days-off reported elsewhere in this issue. That more modest interruption seeks to reduce antiretroviral use in carefully selected patients in order to reduce expense and improve quality of life, not to help the immune system gain permanent control of HIV. Treatment is discontinued for only two days then automatically restarted before the virus has a chance to come back -- not discontinued for years at a time if viral load stays low.
CommentOur impression is that the early HIV treatment and interruption to help build immune control of the virus probably is helping, but not enough for most patients. Some of the newer research into HIV immunity and pathogenesis may ultimately provide the additional help necessary. We need more research on why some primate species (and a few people) do not get infected with HIV, or do get infected but then do not get sick, and whether some of the mechanisms involved could be produced artificially by drug treatment.
It will be necessary to build public-interest advocacy to make sure that needed research happens, since the companies already selling antiretrovirals may not have an incentive to greatly reduce their use.
References
PLOS Medicine. December 2004; volume 1, issue 3: number e70. Open access (no subscription needed) at http://medicine.plosjournals.org/. A search for "interruption HIV" (without the quotes) will find this and related articles in PLOS Medicine.

Vaccine Improves Survival in Monkey Tests

A vaccine tested at the U.S. NIAID clearly improved the survival of monkeys, a benefit not predicted by T-cell and viral load tests. It was predicted by measurements of memory T cells in the first few months of infection -- giving important insights into how HIV disease develops, and how to test HIV vaccines early so that only the best candidates will go into large human trials.
Researchers at the U.S. National Institute of Allergy and Infectious Diseases (NIAID) reported that an experimental vaccine clearly improved the survival of monkeys after infection by SIV (simian immunodeficiency virus), a virus similar to HIV -- even though it did not prevent infection, and did not much improve viral load or total T-cell count.
While the viral load and T-cell count did not predict the greater survival, something else did -- measurement of memory cells (one kind of T-cells) in the first few months of infection. Memory cells make up more than half of T-cells in adults, and early in HIV disease many of these cells are infected and eventually lost. In the monkey test, three to five times fewer of the memory cells were infected in vaccinated animals than in unvaccinated animals.
The vaccine used in this study was a simplified version of an HIV vaccine now in phase II human trials in the U.S. and some other countries.
Besides the possibility of a survival benefit in humans even if a vaccine fails to prevent infection, this is important for additional reasons:
The researchers found an immune response from a vaccine that did help protect the animals. A big problem in HIV vaccine research has been that while it is easy to show immune responses to HIV vaccines, it has been very hard to find "correlates of protection" -- that is, responses that do any good at protecting against HIV-type viruses.
If this result is confirmed in humans, it could give a much earlier indication of which vaccines are promising and which are not. This early information could help with another big problem in vaccine research. Since no one would deliberately infect people with HIV in order to test a vaccine, trials have to study thousands of people for years to prove that a vaccine works. Very few such studies can be done, so it is very important to get the best candidate vaccines into these large phase III trials. An early indicator that can be measured in every patient, and is known to predict survival, would help immensely.
The fact that the monkeys benefited even partly creates a framework for studying HIV pathogenesis (development of the disease) -- and studying how vaccines might work, as well as immune-based or other new kinds of treatment for those already infected. Without the observed benefit to the animals, lots of data could still be collected, but it might be very difficult or impossible to know which findings were meaningful and which were not.
For More InformationNIAID published a press release, "Monkeys Vaccinated Against SIV Survive Longer After Infection" on June 9.
This press release includes references to the two articles, one in Science, and the other in Journal of Experimental Medicine.

Combating AIDS: Search for a Vaccine

Worldwide, approximately 3 1/2 million deaths every year - nearly seven deaths per minute - occur as a result of HIV/AIDS.
Health institutes around the world are seeking better treatments for HIV and a vaccine for the prevention of HIV infection and AIDS. One of those facilities is the National Cancer Institute at Frederick (NCI-Frederick), in Frederick, Maryland, part of the U.S. National Institutes of Health (NIH). At NCI-Frederick, a federally funded research and development center, scientists conduct research into the causes, treatment, and prevention of cancer, AIDS, and related diseases. NCI houses many labs and serves as a major biotechnology resource center for NCI/NIH.
Among the many programs at NCI-Frederick is the AIDS Vaccine Program (AVP), founded in 1987. AVP is an integrated, multidisciplinary program of basic and applied studies aimed at the development of effective vaccines for the prevention of HIV-1 infection and AIDS.
AVP is making headway in its work to find a vaccine. For example, it carries out studies aimed at improving our understanding of the aspects relevant to the development and evaluation of an effective vaccine. The work emphasizes both studies to evaluate candidate vaccines and studies aimed at characterizing basic processes that could be relevant to vaccine development. Due to this work, an extensive panel of analytical techniques has been developed. In addition to providing insights into the basic mechanisms of action of the AIDS virus, these techniques should help provide practical information to help design and develop effective vaccines for the prevention of HIV infection and AIDS.
As part of this work, scientists are gaining a better understanding of the chemical properties of a protein found in HIV. This understanding has allowed them to begin devising procedures to inactivate the ability of the virus to infect.
In addition, AVP is conducting research to identify and understand the genes involved in the human immune response. Many genes are involved in resistance to viral infection and scientists are discovering how certain molecules are involved in activating and inhibiting important immune cells. This information may lead to the discovery of more effective drugs to fight HIV and cancer, with fewer incidents of developing drug resistance.
This is just a very brief sampling of the work being done by the AVP. Many different research studies are being performed to develop a successful vaccine, led by scientists who have been dedicated to understanding and defeating HIV/AIDS since the 1980s.
The AVP is part of SAIC-Frederick's Basic Science Directorate. SAIC-Frederick, Inc., a subsidiary of SAIC, is the operations and technical support contractor for NCI-Frederick. The mission of SAIC-Frederick is to provide scientific, technical, management, administrative, and logistical support to NIH laboratory research and development activities related to the causes of and cures for cancer and AIDS and to other public health issues. SAIC-Frederick scientists conduct basic and applied research in cancer and AIDS and conduct large drug and natural product screening programs. The company also operates and manages the Advanced Biomedical Computing Center, the high performance computing center devoted exclusively to biomedical research. The center provides fully integrated, high performance, scientific computing support to the scientists of the NCI, NIH, and extramural biomedical researchers.

Disposable Hearing Aids Are More Than Meets The Eye by Lerner De Luca

People that are just starting to lose their hearing or have mild to medium hearing loss can find help from disposable hearing aids. Not only can you save money with disposable hearing aids but they also have the same features and quality as traditional ones. An ear expert will test your hearing to make sure that a disposable hearing aid would be right for you and then give you a prescription.
Throw away hearing aids are a little, mushroom like, soft cap that goes inside the ear canal like traditional hearing aids. There life expectancy is up to forty days, the battery dies and you throw them away. There are many positives that disposable hearing aids have over traditional ones such as:
1. There is no long wait while they manufacture the traditional hearing aids. A disposable hearing aid is ready as soon as you fill your prescription.
2. When the battery expires in a disposable hearing aid, you toss it out and buy a new one.
3. People with arthritis or that have problems with changing the traditional hearing aid batteries benefit from disposable hearing aids as they just throw them out and purchase a new one.
4. Because you only wear disposable hearing aids for a month or two, there is not the wax buildup or canal blockage that can occur from regular hearing aids.
5. There is no upkeep or maintenance with disposable hearing aids so no other expenses like traditions ones and if there is a problem with the disposable ones, just take them back for fast replacement.
6. Instead of having to spend a lot of cash to purchase a custom hearing aid, the disposable ones cost approximately a dollar a day. This is far more affordable especially for anyone the lives on a budget.
One drawback is that sometimes a disposable hearing aid is not as comfortable as traditional hearing aids as they not custom made and fitted.
Disposable hearing aids are very beneficial and affordable for those with hearing problems. Visit our site for more details on hearing aids prices and more.

Disposable Hearing Aids Are More Than Meets The Eye by Lerner De Luca

People that are just starting to lose their hearing or have mild to medium hearing loss can find help from disposable hearing aids. Not only can you save money with disposable hearing aids but they also have the same features and quality as traditional ones. An ear expert will test your hearing to make sure that a disposable hearing aid would be right for you and then give you a prescription.
Throw away hearing aids are a little, mushroom like, soft cap that goes inside the ear canal like traditional hearing aids. There life expectancy is up to forty days, the battery dies and you throw them away. There are many positives that disposable hearing aids have over traditional ones such as:
1. There is no long wait while they manufacture the traditional hearing aids. A disposable hearing aid is ready as soon as you fill your prescription.
2. When the battery expires in a disposable hearing aid, you toss it out and buy a new one.
3. People with arthritis or that have problems with changing the traditional hearing aid batteries benefit from disposable hearing aids as they just throw them out and purchase a new one.
4. Because you only wear disposable hearing aids for a month or two, there is not the wax buildup or canal blockage that can occur from regular hearing aids.
5. There is no upkeep or maintenance with disposable hearing aids so no other expenses like traditions ones and if there is a problem with the disposable ones, just take them back for fast replacement.
6. Instead of having to spend a lot of cash to purchase a custom hearing aid, the disposable ones cost approximately a dollar a day. This is far more affordable especially for anyone the lives on a budget.
One drawback is that sometimes a disposable hearing aid is not as comfortable as traditional hearing aids as they not custom made and fitted.
Disposable hearing aids are very beneficial and affordable for those with hearing problems. Visit our site for more details on hearing aids prices and more.