'You're too old to have HIV': Policies proposed to end stigma among elderly

HIV/Aids has been traditionally seen as a disease of younger people. However, many older adults do become newly infected with the virus.

The advent of modern ARVs also allows individuals to live into old age.

Older adults living with HIV are now reporting being doubly stigmatised, as they are branded by both age as well as HIV status.

Dr Gichuki Kariuki, chair of the just-ended Maisha HIV conference said there is now a need to develop and scale up new prevention ways targeting various populations to enhance existing interventions.

“We need to design and implement strategies for reduction of stigma against older people living with HIV while promoting dignity and compassion,” he said in a summary of key proceedings.

Dr Kariuki is also the Health CEC for Nyandarua County.

The seventh Maisha Conference, which took place in Mombasa, provided a platform for policymakers, scientists, communities and partners to share knowledge and insights gained over almost four decades of the HIV response.

At least 27 per cent of Kenyans living with HIV are old – above 50 years – and while some have lived with HIV for many years, others were infected in their old age.

Speakers at the conference said old people are stigmatised by the community and health workers.

"I was asked what I was thinking getting HIV at 70 years," a 73-year-old man who got the virus three years ago said.

Most studies on HIV-related stigma in Kenya focus on young adults but stigma studies from other countries say older adults reported they were ashamed of their illness and some lost friends as a result of their illness.

Dr Lazarus Momanyi, a medical doctor currently working with the National Aids and STI Control Programme (Nascop), said because of stigma, many old people seek diagnosis late, for HIV and for other co-morbidities.

“There's an assumption older people aren’t acquiring HIV, or are not having sex. So we plan for young people not forgetting old people have risks.  When they are diagnosed it's late with very low immunity,” he said.

Most new HIV infections in Kenya are among people aged 15-24, with the incidence reducing with age.

However, most people living with HIV are now above 35 years old.

Momanyi said 68 per cent of all Kenyans on HIV treatment are aged above 35 years.

“An estimated 883,694 of the 1.4 million people living with HIV are aged between 35 and 74 years, many of them diagnosed in their younger years,” he said.

Public Health PS Mary Muthoni, who closed the meeting, said Kenya recorded a reduction of new HIV infections by 78 per cent in the last ten years.

“The HIV response in Kenya is a great example of how multiple sectors working together can be effective,” she said.

“The core principles of a single coordinating authority, a harmonised country strategy, and a comprehensive national monitoring and evaluation framework have synergistically fostered unwavering dedication and collaborative accountability," she said.

"This response is truly impressive and shows how other important health issues can also be tackled successfully.

“While celebrating these achievements is important, our true joy lies in witnessing people living with HIV lead long and healthy lives. We acknowledge the collective efforts that have brought us here.”

Dr Jude Otogo, the executive director for the non-profit Regional Centre on Healthy Ageing, said HIV in old age also predisposes people to non-communicable diseases.

He said Kenya is poorly prepared to tackle NCDs in old people living with HIV.

“WHO has guidelines for the management of healthcare for older persons (50 years plus). As a country, we haven’t prepared to effectively manage the challenge of HIV and the population that is ageing. We should adopt the WHO integrated care guidelines for ageing persons,” he said.

He said most old people with HIV also suffer from pill burden (polypharmacy) – using more than five different drugs a day.

“Some of the drugs alleviate side-effects of ARVs. Many are also taking drugs for comorbidities such as arthritis and diabetes,” he said.