HIV/AIDS Clinical Trials & Seniors

Written by David Mariner with help from Mark Baker & Catherine McCartin

What We Know

• According to the CDC, Individuals over the age of 50 now account for over 11% of AIDS Cases in the United States. Some estimate that between 11% and 15% of U.S. AIDS cases occur in people over the age of 50.¹ AIDS cases among individuals over the age of 50 have increased 22% since 1991.

• Up to 1999, 9.5% of all women diagnosed with AIDS were over the age of 50.²

• More than half of older Americans living with HIV are either African-American or from Hispanic/Latino descent.³

Seniors & HIV/AIDS

• Later Diagnosis: Seniors often are dealing with multiple health issues. This may make it more difficult for a doctor to distinguish between symptoms of HIV/AIDS and other medical decisions, delaying an HIV/AIDS diagnosis. In addition, some medical providers may be less likely to associate HIV/AIDS with older populations. Both of these factors may contribute to the fact that older persons are more likely to be diagnosed at a late stage of infection.

• Immune Response: Regardless of HIV status, our immune system naturally weakens as we get older. This provides an added challenge for HIV positive seniors.

Seniors and HIV/AIDS Clinical Trials

• Age Criteria for Trials: HIV/AIDS trials may exclude trial participants over a certain age or may set limits on the number of participants over a certain age. For example, a recent AIDS Vaccine trial excludes participants over the age of 60 and requires that no more than 10% of trial participants be over the age of 50. This is due, in part, to the fact that these Seniors may have a weaker immune response.

• Health Criteria for Trials: HIV/AIDS trials may also specify that patients be in reasonably good health at the time of study entry. This measurement of over-all health is often measured using the 'Karnofsky Performance Score'. For example, the CPCRA SMART Trial does not have an upper age limit for participation, but does require a Karnofsky score greater than or equal to 60 (indicating the person does not require considerable assistance or frequent medical care).

• Research on Seniors: Due in part to a lack of awareness of HIV/AIDS among seniors, there is little research that specifically addresses this population both in treatment research and prevention research.

1. The CDC numbers are based on data acquired between 1991 and 1996. See MMWR, January 23, 1998, 47(02);21-27. Organizations such as AIDS Action and the National Association of HIV over Fifty estimate the current number to be between 11% and 15%.
2. AIDS Action, 'Older Americans and HIV', Policy Facts, June 2001
3. AIDS Action, 'Older Americans and HIV', Policy Facts, June 2001