To the young and healthy, sex and death aren't related. AIDS is something you read about, something that happens to gay men or junkies. Heterosexuality, white skin and a bank balance make you immune to it.
"I knew I shouldn't," the woman tells me. "But he said he was okay. And he didn't seem like he'd have anything."
Few people do "seem like they'd have anything." But HIV is an equal-opportunity virus. It doesn't look for gay people or intravenous drug users. And it doesn't worry about the age of its victims.
Drive through Sun City and look at the old-timers tooling around in their golf carts, and you might think about heart attacks, varicose veins, prostate problems. You might think about death, but you don't think about sex, and you don't think about AIDS. They don't "look like they'd have anything."
But people over 60 are the fastest-growing group of people getting infected with HIV locally, according to Debby Elliot, program coordinator of Phoenix-based Care Directives.
More than 10 percent of all AIDS cases nationally occur in people over 50, and 25 percent of those cases are in people over 60. People older than 70 constitute 4 percent.
In 1994, 8,995 women over the age of 44 had been diagnosed with AIDS, according to the Centers for Disease Control. At the time of diagnosis, 14 percent of these women were older than 65.
Young people typically regard old people as sexless. But humans are sexual beings throughout their lives. If in good health, people can be sexually active even into their 90s. Studies on sexuality in older adults are limited, but one national survey found that their average frequency of sexual activity is two to four times a month. Of healthy men older than 80, 29 percent were having sex at least weekly, while only 38 percent were completely inactive. Asked to rate their enjoyment of sex, 63 percent said it was "great" or "moderate."
Old people, when sexually active, are not necessarily monogamous. The study found that between 2.5 percent and 3 percent had two or more sexual partners in the previous year.
And the figures given for geriatric HIV infection are almost certainly too low. HIV infection of elderly people may be underreported owing to misdiagnosis. AIDS-related dementia can be mistaken for Alzheimer's disease, and other AIDS symptoms can be seen as part of the aging process.
The HIV virus may be transmitted more easily in older people. Post-menopausal thinning of the vaginal wall makes abrasion during sex more likely.
Having been infected, elderly people are more likely to be hit hard by the virus. HIV weakens the immune system, causing ailments that would normally be minor to become serious and often deadly. And elderly people tend to have weaker immune systems anyway.
Why are elderly people getting infected?
"Because they don't think they can be," says Elliot. "They don't think of HIV as a threat to them. And at their age, they're not going to get pregnant. So they have unsafe sex. At that age, they find themselves widowed or divorced; they're single again, and they don't realize the danger."
Elliot has several elderly clients who became infected with HIV through heterosexual encounters. All declined to be interviewed, but she told me about some of these cases. The names have been changed.
Kathleen is a 60-year-old divorced woman with grown children. She lives in a suburb of Phoenix. Six years ago, she started a relationship with Paul, a man she met through work. The couple had a mutual friend, Tony, who was HIV positive. They provided friendship and support to him until his death in 1992. Kathleen was shocked when she read in his obituary that he was "survived by his companion Paul."
She confronted Paul, and he admitted that he had been involved with Tony sexually. Kathleen took a test and learned that she was HIV positive. So was Paul. He has since died, and Kathleen is living with AIDS.
Todd and Karen are 70 and 71 years old, respectively. They have been married 44 years and have four grown children. They spent most of their lives in the Northeast until retiring to Florida five years ago. They then decided to move to Arizona to be closer to Todd's siblings.
They had sold their house and made their moving plans when Todd was diagnosed HIV positive. They were afraid to tell any family members. They went ahead and moved to Arizona, fearing that their family would "suspect something" if they canceled the move.
Once they got here, they hoped they'd be able to tell their relatives. But when they tested the waters by talking about people with AIDS, they heard comments like "they deserve it" and "I wouldn't want to be near someone with AIDS."
They went on living with their secret, lying to their family about medical and social-service appointments they attended. Finally they moved out of Arizona.
"It's a serious problem," says Debby Elliot. "While rates of HIV infection among gay men either stays the same or actually goes down, it's going to keep on increasing among older people until they realize that it affects them as much as anybody else."
What does her organization plan to do about it? "People have to be educated about it. So we're offering HIV tests in Sun City on June 5."
To protect the confidentiality of those being tested, the location of the test is not being made public. But anyone who wants to make an appointment can call 584-0040. Tests are available from 9 a.m. to 2 p.m.
Amy Melcher, a volunteer educator for Volunteer AIDS Education Network, says her organization receives few requests from older people.
"There's the same problem we have with teenagers," she says. "They think they're invincible."
But Cari Merrill, the organization's community HIV prevention coordinator, believes people charged with educating the public about AIDS are misguided.
"I think educators don't target them, because they don't think of them as being at risk. We tend to assume that older people don't have sex or use needles. So educators don't target them with the information they need," Merrill says.
This is a problem that has been on the cards for a while. Two years ago, Nancy Williams, a 63-year-old heterosexual woman who had been diagnosed as having HIV, told New Times, "I've lived in Sun City. The people out there, I'm quite sure, have unprotected sex. I guarantee you because they're older does not mean they're not sexually active."
She was obviously right. And people, young and old, continue to sentence themselves to death by having unprotected sex with people who "don't seem like they'd have anything."
Contact Barry Graham at his online address: [email protected]
