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Delayed diagnosis of HIV among the elderly population in Salvador, Brazil
I. Dourado1, C.A.L. da Silva1,2, S. MacCarthy1,3, M.C. Camargo2, M. Rebouças2, S. Stolze2
1Federal University of Bahia, Instituto de Saúde Coletiva, Salvador, Brazil, 2Centro Estadual Especializado em Diagnóstico, Assistência e Pesquisa, Bahia State Dept. of Health, Salvador, Brazil, 3Harvard School of Public Health, Boston, United States
Background: The profile of
AIDS cases in Brazil
has changed dramatically over the past 60 years in response to a complex
interaction of factors. Despite studies documenting that elderly continue to be
sexually active well beyond their reproductive years, their potential risk for
HIV transmission is often ignored. Nationally, the Brazilian Ministry of Health
has drawn attention to HIV/AIDS among individuals beyond reproductive years by
launching a campaign and dedicating the most recent Epidemiological Bulletin on
individuals over the age of 50.To explore this phenomenon in Salvador, the
capital city of Bahia in Northeast Brazil, we investigated the delay in the
diagnosis of HIV among an elderly population.
Methods: We conducted a
retrospective review of medical records at the Public State
Reference Center
for HIV/AIDS. The sample (n=149) included all patients over 60 years of age
between September 2001 and December 2009. Delayed diagnosis was defined as
those individuals who received their first positive test for HIV in < 1
year prior to their diagnosis of AIDS.
Results: In the sample, 69.8%
were male, 75.9% identified as heterosexual, 30.2% were married and 24% were
widows. With respect to education, 29.1% completed high school and 13.6%
completed college. The majority presented with co-morbidities (61.5%) such as
hypertension, diabetes, or cardiac problems and furthermore reported that they
did not use condoms during sexual relations (55.7%). 74.5% were AIDS cases, of
whom 54.3% had less than 12 months between the time at which they were
diagnosed with HIV. During the study period 6 deaths occurred.
Conclusions: This study underscores the need for
programs and policies to further address the changing needs of HIV positive
people in Brazil,
with special attention to the elderly.
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