Too Old to Test? Prevalence and Correlates of HIV Testing Among Sexually Active Elderly Adults

Background: Elderly adults account for 18% of HIV diagnoses in the U.S. Sexual activity has increased among the elderly; in addition, the elderly are also more likely to be HIV-diagnosed late in the course of their disease compared to younger people. Nationally representative estimates and correlates of HIV testing have yet to be determined among this population. We calculated the prevalence and correlates of having ever been tested for HIV among sexually active elderly adults.

Methods: We analyzed data from the General Social Survey from 2008–2014 and limited the analysis to elderly (age: 65–89 years) respondents who reported at least one sex partner in past 12 months (N=458). HIV testing prevalence was calculated by age, gender, race/ethnicity, education, marital status, income, sexual orientation, condom use at last sex, and HIV-related risk behaviors - injection drug use, crack/cocaine use, 3≥ opposite-sex partners in the past 12 months, ever exchanged sex for money, and sex with a same-sex partner (men only). Prevalence ratios and 95% confidence intervals were calculated based on logistic regression models.

Results: Overall, 14.6% of the sample of sexually active elderly adults (N=74) have tested for HIV, and 1.6% reported testing in the past 12 months (N=11). After adjusting for significant study variables, elderly adults age 65–70, not married, and self-identified as gay or bisexual were more likely to have tested for HIV than adults 71 years or older, married, or self-identified as heterosexual. No statistically significant difference in HIV testing prevalence was observed for elderly adults with HIV-related risk behaviors

Conclusions: Approximately 85% of sexually active elderly adults have never tested for HIV, and increases in testing were not observed among those at elevated risk for HIV infection. Strategies are needed to increase HIV testing among elderly adults at an increased risk for HIV.