WASHINGTON – Newly divorced after 23 years of marriage, Jane P. Fowler was hesitant to re-enter the dating scene. When the then 50-year-old woman finally began seeing someone, it was a man she had known for years — a man she now believes infected her with the AIDS virus.
"I had no idea what was out there," said the Kansas City, Mo., woman. "I was an older woman. I did not have to worry about becoming pregnant."
Fowler, now 67, is part of the new face of HIV — which increasingly is heterosexual, older and grayer.
"Women after menopause are not going to use condoms because they're not afraid of getting pregnant anymore. Viagra is spreading like chewing gum. Usually, medical providers don't even ask about their sexual life," said Monica Dea, a coordinator with the Center for AIDS Prevention and Studies at the University of California, San Francisco. "These people are continually getting infected."
While there is no nationwide system that tracks HIV infections, the Centers for Disease Control and Prevention says that among Americans who have AIDS, the percentage who are over age 50 rose steadily in the 1990s.
It has concerned government officials enough that they are now collecting data to assess the situation.
"It is an area we want to be concerned about," said Robert Janssen, director of the CDC's Division of HIV/AIDS Prevention. "Potentially there is a risk of there being increases in new infections in older people."
Fowler and others complain that the government's prevention efforts rarely target older Americans. Posters and campaigns do not usually feature an older face, and doctors sometimes discourage the elderly when they question whether they should be tested, advocates say.
"One of our biggest problems is getting clinicians to take sexual histories of older people," Fowler said. "This is something we have to change. People my age, they'll ask me what an 'STD' (sexually transmitted disease) is. They think 'VD.' We were the venereal disease generation. We have to get everybody thinking about that."
Activists are also concerned that little testing has been done to see if there is any adverse reaction between HIV/AIDS medication and traditional aging drugs. "All of the drug trials were done on younger people," said Jim Campbell of Boston, the board chairman for the National Association on HIV Over 50.
One reason for the neglect, many say, is Americans' attitudes toward older people and sex.
"We're a youth oriented culture," Campbell said. "We don't like to think of our parents or our grandparents having sex."
But studies show many older Americans maintain active sex lives.
A 1999 AARP survey found that more than half of men and women age 45 to 59 reported that they had sex once a week or more. One in four men and women over the age of 75 said they too had sex at least once a week.
"We must all protect ourselves," said Fowler, who has formed a group called HIV Wisdom for Older Women. "We have to get past this that older people aren't part of this equation because older people don't have sex."