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In this issue

Gus Cairns
Published: 01 July 2010

Life never ceases to throw surprises at us, including things we shouldn’t be surprised by. One of those is old age. As the failure of young people to get pensions shows, none of us really thinks we’re ever going to get old.

“Restricted, boring and bleak” was the description of age, as perceived by youth, in one publication – not some Generation X novel, but a sober paper issued by the Department for Work and Pensions on why young people don’t save.1

They’re wrong. A recent large study in the US by Princeton University and Gallup used phone polls to quiz 340,000 people aged 18 to 85 on how happy, sad, stressed and sane they felt.2 Who were happiest? People in their 80s.

But what happens if you had good reason to think you’d never get old? That’s the position many people with HIV who were diagnosed before combination therapy have found themselves in.

As Lisa Power’s analysis of the 50 Plus survey shows (Will a long life be a good one?), a high proportion of the people with HIV who answered the survey regarded becoming old with dread – in particular because, having not made provision for old age, they’d be reliant on dwindling and possibly ignorant public services.

One positive finding of the survey, however, was that older people with HIV reported greater ease with disclosure of status - perhaps being less likely to worry what people think. It could suggest that HIV-positive octogenarians may be less isolated, and have not quite such a bleak time of it, as they are anticipating right now.

Our other pieces also hinge on unwelcome surprises. Midwife Sally Farthing, writing about the other end of life (Happy families), finds that if mums with HIV are diagnosed and treated in time, the chance they will pass their virus on to their baby is becoming minuscule – in the region of one transmission per 200 births.

Yet the actual transmission rate, having plummeted in the 1990s, is staying stubbornly at about four times that rate – one in 50. Apart from a couple of freak transmissions, most of those excess infections represent occasions when obstetricians, finding a mother they’ve never seen before in the labour ward, get a nasty surprise when they test her for HIV. Despite everything they can do then – caesareans, AZT drips, postnatal treatment for the baby – some kids still get infected.

Almost always, the woman has stayed away because she fears a worse nasty surprise, that she’ll come round to find herself with a bouncing baby – and a deportation order.

Finally, we had another surprise last month when two presentations at the Microbicides Conference (Are lubricants safe?) found that many of the lubricants recommended for use with condoms may actually make people more vulnerable to HIV.

Safer-sex guidelines won’t change unless larger studies confirm these findings, but it’s a reminder that as the epidemic approaches its own middle age, the simplest pieces of research can still throw curve balls at us. We’re sure there will be more surprises along the way.

References

  1. Pettigrew N et al. Live now, save later? Young people, saving and pensions. Department for Work and Pensions Research Report No 438, 2007.

  2. Stone AA et al. A snapshot of the age distribution of psychological well-being in the United States. Proceedings of the National Academy of Sciences, early online publication, doi: 10.1073/pnas.1003744107, May 2010.
This content was checked for accuracy at the time it was written. It may have been superseded by more recent developments. NAM recommends checking whether this is the most current information when making decisions that may affect your health.
Community Consensus Statement on Access to HIV Treatment and its Use for Prevention

Together, we can make it happen

We can end HIV soon if people have equal access to HIV drugs as treatment and as PrEP, and have free choice over whether to take them.

Launched today, the Community Consensus Statement is a basic set of principles aimed at making sure that happens.

The Community Consensus Statement is a joint initiative of AVAC, EATG, MSMGF, GNP+, HIV i-Base, the International HIV/AIDS Alliance, ITPC and NAM/aidsmap
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This content was checked for accuracy at the time it was written. It may have been superseded by more recent developments. NAM recommends checking whether this is the most current information when making decisions that may affect your health.

NAM’s information is intended to support, rather than replace, consultation with a healthcare professional. Talk to your doctor or another member of your healthcare team for advice tailored to your situation.