Doug PollardHIV & Ageing in New York
Sean Cahill
DOUG: The new Baillieu government here in Victoria has pledged AU$200,000 for research into HIV and Ageing – accelerated ageing due to HIV or maybe the drugs or a combination of the two. We’re not entirely sure; is a problem world-wide but a recent report put together by the Gay Men’s Health Crisis in New York is providing a springboard for action, there. US gay radio programme: This Way, Out. Sent their reporter, Sheri Lunn to talk with Gay Men’s Health Crisis [executive] director Sean Cahill. In his New York office.
[playback starts]
“SHERI LUNN: So, Sean. Tell me little bit about Gay Men’s Health Crisis, first.
SEAN CAHILL: Sure.
SHERI LUNN: So our listeners understand what y’all do.
SEAN CAHILL: Yes.
SHERI LUNN: Then we’ll go right into the report.
SEAN CAHILL: Great. Gay Men’s Health Crisis was the first AIDS organisation in the world. We came together in 1981 when this epidemic first emerged in the gay-male community in New York City; today, we are an organisation that provides HIV prevention and care services to about 10,000 New York residents. We also do a lot of advocacy at the local State and Federal level, on public policy issues. This report we put out was really aimed at raising the issue of older adults and HIV, putting it on the radar screen of policy makers and health-care providers. Locally and around the country.
SHERI LUNN: There hadn’t been a lot of research prior to this report coming out, is that right?
SEAN CAHILL: That’s right. Until the Antiretrovirals came-about in the mid-1990s most people with HIV didn’t live until old age. But with that wonderful development also comes some new challenges; we know that about a third of our clients are 50 and older – nationally – it’s about the same, about a third of people with HIV in America are over 50. We know that with older adults in general, as all of us age we tend to develop health conditions. Things like diabetes or high blood pressure, high cholesterol; one of the questions and concerns we have is how does having HIV interact with some of these other conditions but also how do the medications interact if at all?
SHERI LUNN: We don’t really know that, yet?
SEAN CAHILL: We know very little about that.
SHERI LUNN: Is there some research happening now?
SEAN CAHILL: Yes.
SHERI LUNN: There is.
SEAN CAHILL: Well, there is. There’s a lot of great researchers out there and one of them is [Professor] Amy Justice at Yale Medical School. She does a lot of work with the VA system. Then the National [indistinct] of Health has stepped-up its work in this area, just in the last year. So there’s a lot of good stuff in the pipeline but that research is often three, 5-year studies and so right now what’s in the literature is kind-of limited.
SHERI LUNN: A lot of times as folks get older, they tend to isolate - - -
SEAN CAHILL: Yes. You’ve hit on a really important issue: social isolation. It’s not only an important issue for people living with HIV as they age but it’s also an issue for people in terms of, vulnerability. To HIV infection. Even though AIDS is not a gay disease HIV disproportionately affects gay men still, in this country. There’s research which shows older people living with HIV in general – whether they’re gay, straight, female, male – can have greater rates of social isolation. Living alone, maybe being estranged from their families because of homophobia and family rejection, thing like that – so that’s a very important issue. In the data we see from the Centre of Disease Control the bulk of new infections amongst gay men who are Black or Latino, is appearing among young men. Teens and 20s. But the bulk of new infections amongst white gay men are occurring amongst guys in their 30s or 40s.
SHERI LUNN: M’mm.
SEAN CAHILL: (and) We’re not sure why that is. But certainly, we do know [indistinct] a lot of older, gay men. There is social isolation which can lead to low self-esteem. Which can lead to substance use and all of those factors increase somebody’s vulnerability to HIV risk behaviour and HIV infection. One of the things that’s been reported in the social work literature is they might have a close friend, in a seniors’ centre and they get close to the person, they disclose their status to the person. It’s been widely reported that a lot of times there’s then unauthorised disclosure of that person’s HIV status – so, that’s an issue and then there’re a lot of misperceptions about how HIV is transmitted. Some of the ignorance we saw back in the ‘80s where people with HIV had trouble getting their hair cut, couldn’t get served in a restaurant because of irrational fears about casual transmission. That actually still exists amongst some of the older-age cohorts in seniors’ centres. Even amongst staff. So it’s really critical that seniors’ settings do social competency training of their staffs, certainly – and also, set a tone with the people they serve – that you can’t get HIV from touching the same door knob as somebody with HIV who’s just touched it. You can’t get it from sharing the same fork that’s washed in the dishwasher. Believe it or not, those are some of the misperceptions that are out there.
SHERI LUNN: You have some statistics?
SEAN CAHILL: M’mm, m’mm.
SHERI LUNN: Here from the “Growing Older with the Epidemic: Ageing and HIV Report”.
SEAN CAHILL: Right.
SHERI LUNN:
[reads]
‘Amongst older adults ages 49 to 59, 50 per cent of women and 55 per cent of men were sexually active in the previous 6-months. But we’re looking at some women who had unprotected sex within the last decade’
SEAN CAHILL: Yes. A lot of older women who are widowed or divorced, they may have been with their husband. For decades. (and) Many of them have not dated in a long, long time. When they were sexually active prior to menopause and now that they’re beyond the age of getting pregnant often they don’t think they’d need to use protection. So that’s an issue and yeah, that data we cite in the report are from a number of studies that show a lot of older women are engaging in unprotected sex. Perhaps the risk they’re putting themselves at is lower than the risk of a gay man, having unprotected sex – they’re still at-risk.
SHERI LUNN: (and) Transgender women.
SEAN CAHILL: M’mm, m’mm?
SHERI LUNN: Are experiencing HIV at a much higher rate.
SEAN CAHILL: That’s true. Transgender women, there aren’t a lot of big survey data sets for trans [gender] women. Mostly, they’re convenient samples. But there’s still good data. What we’ve seen in that data is trans-women experience the highest rate of any population group – even higher than men who have sex with men. Something – like, about 10 per cent of gay and bi-sexual men in this country are HIV . The rate we see amongst trans-women are even higher – they’re – like, 30. 40 per cent. It’s particularly true of Black and Latino trans-women.
SHERI LUNN: So, Sean. Where do we go from here?
SEAN CAHILL: This kind of interview is really helpful. To get the word out. This report’s on our website: GMHC.org. Another opportunity we have coming up is the Older Americans Act, is being re-authorised next winter and so we’re analysing the Older Americans Act that gets re-authorised every 5-years. It basically funds seniors’ services at the State and regional levels; we’re going to be looking for ways that we might want to amend the Older Americans Act and then we’re also going to work, here. In New York State with our State Department of Ageing to help them draft their 5-year plan. For how to spend the Older Americans Act’s funds, the Federal government gives them. We encourage folks around the country to do the same ‘cause this is the moment, to do that.
SHERI LUNN: We’ve been talking with Sean Cahill, managing director of public policy, research, community health at Gay Men’s Health Crisis in New York City. Thank you for joining us.
SEAN CAHILL: Thank you, Sherry.
UNIDENTIFIED: That was This Way Out’s SHERI LUNN. Reporting from New York City.”
[playback ends]
DOUG: That was a piece from our sister-programme in the US: This Way Out http://www.thiswayout.org/. A regular, weekly programme of GLBTI news and current affairs – not unlike what we do here on Joy but of course, it’s only one programme. Not a whole station.
Transcription Copyright © 2010
