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Heterosexual transmission and late-stage disease at presentation are more common in adults aged 50 and older who are newly diagnosed with HIV.

Patients aged 50 and older who were newly diagnosed with HIV often reported heterosexual transmission and were more often women when compared with those younger than 50, according to an analysis of patients in New York State that was published in JAIDS.

The findings “suggest a need for enhanced clinician education and sexual health discussions with this adult population,” Deepa T. Rajulu, MS, and colleagues wrote.

The study compared characteristics of patients aged 50 years and older with patients younger than 50 years diagnosed with HIV and reported to the New York State HIV registry by December 31, 2021. Researchers aimed to better understand the characteristics of patients aging with HIV.

Between 2012 and 2021, the proportion of patients diagnosed with HIV who were aged 50 years and older ranged from 16% to 20%, according to the study. Among 2,123 new HIV diagnoses in the state in 2021, 18% were for patients aged 50 years and older.

Impact of Heterosexual HIV Transmission

The proportion of women diagnosed with HIV in 2021 was 32% among patients aged 50 and older compared with 15% among patients younger than 50 years.

“Although nearly 60% of persons diagnosed with HIV younger than 50 years reported MSM [male-to-male sexual contact] risk in 2021, the proportion was much lower (23%) in the 50 years and older age group,” researchers wrote. “Furthermore, the percentage of persons with reported heterosexual contact transmission risk or unknown risk was higher among persons aged 50 years and older compared with the younger than 50 years age group.”

Specifically, heterosexual contact transmission risk was 33%, and unknown risk was 39% in the older age group compared with 17% and 20%, respectively, in the younger group.

Among patients with new diagnoses in 2021, those 50 years and older were more likely to have stage 3 HIV diagnoses: 36%, compared with 17% in patients younger than 50 years. The study defined stage 3 HIV as an AIDS diagnosis within 30 days of the initial HIV diagnosis.

“A greater rate of stage 3 HIV diagnoses in persons aged 50 years and older emphasizes the need for specialized HIV testing and treatment, care for comorbidities, and social supports for this aging population,” researchers advised.