WEDNESDAY, June 18 (HealthDay News) -- While older adults may
seem the least likely group of Americans to become infected with
HIV, a new study suggests it would be cost-effective for doctors to
routinely give AIDS tests to some sexually active people in their
60s and 70s.
In fact, an HIV diagnosis and subsequent treatment could
potentially add an average of six to nine months to an older
person's life, said study co-author Dr. Douglas K. Owens.
"Just because you have someone who's older doesn't mean you
shouldn't think about HIV and HIV screening," said Owens, a senior
investigator at the VA Palo Alto Health Care System in California
and professor of medicine at Stanford University.
Older Americans have been largely overlooked throughout the
years of the AIDS epidemic, although they are hardly immune. The
federal government only recommends routine HIV testing up until the
age of 64.
Still, an estimated 20 percent of HIV patients are older than
50, Owens said. And research with older veterans has suggested that
as many as one in 200 is infected with the virus that causes AIDS,
he said.
The AIDS threat facing older Americans is often ignored, because
"people find it difficult to imagine their parents and grandparents
being sexually active," said Rowena Johnston, vice president of
research with the Foundation for AIDS Research.
For the new study, published in the June 17 issue of the
Annals of Internal Medicine, Owens and his colleagues
created a mathematical formula to determine the costs and benefits
of routinely testing people aged 55 to 75.
The researchers found that it's cost-effective to test people in
that age group if the prevalence of undiagnosed HIV infection is
greater than 1 in 1,000 and those being tested have sexual partners
at risk of infection.
They reported it may cost $30,000 in tests to lengthen a
sexually active 65-year-old person's life by something known as a
"quality-adjusted life year," a complicated measurement that takes
into account the difficulty of life during illness. On average,
diagnosing a 65-year-old with HIV instead of allowing him to remain
untreated could lengthen his life by six to nine months, Owens
said.
"That's actually a lot. That's a pretty big change," he said.
"Many of the interventions we do change life expectancy by a week,
a few weeks, maybe a month."
AIDS tests typically cost from $10 to $70, Owens said.
Johnston said doctors with older patients "should to be aware
they may be carrying their own biases. It's worth taking into
account the person's sexual history and whether they have risk
factors."
Still, some observers may question the study's assumption that
more than one in 1,000 older adults have HIV and are undiagnosed,
said Frank Myers, director of clinical epidemiology and safety
systems at Scripps Mercy Hospital in San Diego.
"This study, with its assumptions of HIV prevalence, will not be
enough to change HIV screening recommendations by itself," Myers
said. But, he added, he hopes the research will motivate
health-care providers to ask patients about HIV risk factors and
target them with messages about prevention.
More information
For more about older adults and AIDS, visit the
Foundation for AIDS Research.