NEW YORK – While volunteers passed out cups of Jell-O to the white-haired lunch crowd at a senior center, another group was distributing something that didn't quite fit amid the card games and daily gossip: condoms. "You're giving out condoms," 82-year-old Rose Crescenzo said with a wistful smile, "but who's going to give us a guy?"
But this was no joke.
The condom giveaway is part of an effort by New York City's Department of Aging to educate older people about the risks of contracting the virus that causes AIDS. After the condom giveaway, free HIV testing was offered.
AIDS education of the elderly has become an important issue as antiretroviral drugs that can keep patients living into their golden years changes the face of AIDS. Experts warn that ignorance about HIV among seniors can lead to new infections.
And those infections are happening. A physician from Howard University Hospital in Washington recently diagnosed unsuspected HIV in an 82-year-old.
So HIV educators are taking their message of prevention to senior centers and other locales where older people meet. They also hope to create a welcoming environment for people who already have the virus.
New York City has the most HIV cases of any U.S. city — nearly 100,000 — and is considered a leader in the area of AIDS education for seniors, with the City Council having budgeted $1 million toward HIV education for older people.
But smaller-scale campaigns are also under way elsewhere.
Nancy Orel, a professor of gerontology at Bowling Green State University in Ohio, is organizing a workshop for seniors that will include free condoms and HIV tests.
"Unfortunately, most individuals have the perception that sex ends at, what, 32?" Orel said. "And many older adults report that when they go to see their physicians, the physicians don't ask if they're sexually active."
The program at the Peter Cardella Senior Center would have been unthinkable back when AIDS was known as a disease that strikes its victims young and kills them in their prime. But the aging of America's AIDS population has changed that.
"Often older people do not concern themselves with HIV and AIDS because they assume that they are not at risk, and that can be a tragic mistake," said Edwin Mendez-Santiago, New York City's commissioner of aging.
Frank Garcia, 72, happily pocketed his supply of official New York City condoms, which are packaged with a subway logo.
"I think it's a great thing," he said. "We used to go to the drugstore and wait for an hour or two before we got up the nerve to ask for them. Your parents didn't talk about it. Everything was street-taught."
A study last year by the AIDS Community Research Initiative of America projected that within the next decade, the majority of HIV-infected New Yorkers will be over 50.
Dan Tietz, executive director of the AIDS research group, said HIV education is needed at senior centers, where the average age is more like 70, because "we know that people are still having sex well past 65."
Dorcas Baker, who directs an AIDS education center in Baltimore, said health officials there began HIV prevention programs at senior centers in 2005.
"We call it the silent epidemic because no one thinks seniors are sexual or that they're using drugs," she said.
Some seniors tell AIDS educators the disease doesn't affect them because they are not having sex.
"We challenge them by saying, 'You're a grandmother, you're a mother, you're a sister, you're a neighbor,'" Baker said. "They can also help to raise awareness even if they're not active themselves."
People aged 50 to 64 accounted for 14 percent of new HIV diagnoses in 2005, while those over 65 comprised only about 2 percent of HIV diagnoses, according to Dr. Bernard Branson, associate director for laboratory diagnostics in the Division of HIV/AIDS Prevention at the Centers for Disease Control and Prevention.
At the Peter Cardella Center in Queens, 66-year-old AIDS educator Edward Shaw recounted his own 1988 diagnosis and warned: "If you're still having sex, you need to know about HIV/AIDS."
Many of the seniors ignored him as they chatted with friends and settled in for pork chops and green beans.
"I think it should be done in areas where it's really needed," said Julia Karcher, 82. "These ladies are all by themselves for years and years and years."
But Marie Tarantino, who gave her age as "39-plus," said lonely seniors might take unwise risks.
"They might pick somebody up on the street," she said. "They just think that at a certain age they can't get pregnant. They don't think they could get a sexually transmitted disease."
And Crescenzo, who lost her husband of 62 years last October, did take the condoms.
"If I get a date," she said, "I'm going to use one of these."