Managing Social Change

In this section people with HIV discuss the personal and social implications of ageing, and discuss their strategies for coping with change.

Each section includes practical suggestions which may help meet the needs of people living longer with HIV. Looking beyond HIV to a fuller life and being able to see the person not just the disease is an important mantra for many individuals to achieve this personal goal. This may be especially so for people who were diagnosed in the 1980s—whom were often given a death sentence back then and may not have prepared themselves to be alive 20 years later.

Sex

A commonly held view about older people is that they are either asexual or exclusively heterosexual. However, research has shown that older people are sexual and that sexual expression is important for health and wellbeing and that some older people are gay, lesbian, bisexual, transgender and intersex or may be a sex worker.

For many people as they get older sex can lessen in importance compared with when they were younger. For others it is still an essential part of their life. You may not be defined by your sexuality or your HIV status, but whatever your path is, this part of your life is important. This chapter covers some ways for you to achieve your sexual desires.

Negotiating sex can always be a challenge; however we often gain experience and confidence as we age. No longer fumbling teenagers, we may have a better understanding of intimacy and sexuality. Whether looking for an intimate connection or just sex, life experience may assist us in meeting our needs.

What can you do?

Get out and about; explore experience and enjoy.

Go by yourself if you feel comfortable, or ask a friend along for company.
Aim for fun and see what happens.
You never know who you might meet!

Use the world wide web as an opportunity to socialise online or meet socially

There are websites that cater specifically to older gay men and their admirers, people over 50, volunteers and all sorts of social networking sites.

CAFFMOS “for mature gay men and gay daddies”
Extensive dating for mature gay men and their admirers, worldwide. Photos, pen-pals, chat-rooms, and links to other senior sites. Includes a substantial number of members in Australia. www.caffmoscommunity.com [1]
Club Silver Gay personals site dedicated to mature gay and bisexual men, and their admirers. www.clubsilver.org [2]
Fridae A social networking site for gay/bi men of all ages. Fridae labels itself as ‘empowering Asian men’. Whilst it is not exclusively for older guys it attracts a large older group. www.fridae.com [3]
Elder TG (transgender) A USA support group for transgender individuals aged 50-plus and for their partners, friends, family and allies. www.forge-forward.org [4]
Mature Aged Gays (MAG) A peer support, social and educational group targeting mature age men 40-plus who have sex with men, regardless of how they choose to identify themselves. http://www.magnsw.org/ [5]
Prime Timers (USA) “The purpose of our organization is to provide mature gay and bisexual men, and their admirers, with opportunities to come together in a supportive atmosphere to enjoy social, educational, and recreational activities.”
www.primetimersww.org [6]
‘Planning for later life as a lesbian, gay man, bisexual or transgender person’ Information Sheet from ‘Age Concern’ in the UK: information for older lesbians, gay men and bisexuals planning for later life. www.ageconcern.org.uk [7]
50plus Online Magazine (USA) A general readership web magazine for people ages 50-plus. The relationships section includes articles on gay and lesbian ageing. www.50plusmag.com [8]
The Centre for Volunteering Volunteering is as diverse as the huge number of Australians currently involved. Visit their site to find out about hundreds of volunteering opportunities. www.volunteering.com.au [9]
Chatmag.com “Comprehensive List of AIDS/HIV and Poz Chat Rooms on IRC and The Internet”. They’re not all heterosexually-focused, but you’ll find what you’re looking for. www.chatmag.com/topics/health/aids.html [10]
PositiveSingles.com Dating site for folks with all manner of sexually-transmitted infections, including herpes as well as HIV. www.positivesingles.com/ [11]
Poz.com chat A chatroom for HIV-positive heterosexuals. http://hiv-aids.poz.ca/chat/hetero/ [12]
PozMatch.com Personals ads from the Living Positive Community. Global. All-inclusive. www.poz-match.com/index.php?page=index [13]
Touching Base Inc. Developed out of the need to assist people with disabilities and sex workers to connect with each other, focusing on access, discrimination, human rights and legal issues and the attitudinal barriers that these two marginalised ommunities can face. General Enquiries: nfo@touchingbase.org [14]
PozVibrations.com A fun & secure community environment to help you find a match regardless of sexual orientation, race, gender or religion. HIV+ Dating Australia. www.pozvibrations.com [15]

Have safe sex

Use condoms with a water-based lubricant to avoid passing on HIV and protect you and your partners from some other STIs [16][Sexually Transmissible (or Transmitted) Infection] Infections spread by the transfer of organisms from person to person during sexual contact. Also called venereal disease (VD) (an older public health term) or sexually transmitted diseases (STDs). . There is a very low risk of passing on HIV through oral sex, but using a condom or dental dams will also protect you and your partners from some other STIs.

Remember PEP is available

Accidents can happen. If you think you may have exposed another person to HIV, find out where they can get PEP treatment to prevent HIV infection taking hold.

PEP (post-exposure prophylaxis) must be started within 72 hours of exposure, but within a few hours is best.

For more information about PEP and where it is available, call your nearest major hospital, call your AIDS Council, or go to www.getpep.info [17]

Viral load [18]A measurement of the quantity of HIV RNA in the blood. Viral load blood test results are expressed as the number of copies (of HIV) per milliliter of blood plasma. & infectiousness

HIV is still present, even if you have an undetectable viral load. The virus [19]A small infective organism which is incapable of reproducing outside a host cell. remains in very small amounts, which are unable to be accurately measured by current blood tests.

It is possible to have a low or undetectable blood viral load, but higher levels of HIV in other body fluids such as semen, vaginal fluids and the fluid lining of the rectum and anus. This would increase the chance of passing on HIV to your partners.
While research suggests an undetectable blood viral load reduces the risk of passing on HIV, it has not yet been proven to completely eliminate the risk. Having an undetectable viral load result at your last test is not a substitute for safe sex.

Secondary infections

Having another infection when you are HIV positive places further stress on your immune system as well as makes the other infection more serious.

If you have a sexually transmissible infection (STI) as well as HIV, then both the STI and HIV can be easier to pass on to your partners. Some STIs can also increase your viral load and decrease your CD4 count. Get regular sexual health check-ups (blood and urine tests as well as throat, vaginal and anal swabs). Many STIs do not have symptoms.
There is an increased risk of hepatitis B transmission through anal sex.

If you and your partner are both HIV positive and do not use condoms, there is a possible risk of being exposed to a different strain [20][HIV strain] Any subgroup of the HIV species. Because HIV mutates very easily, there are many different strains (and may be multiple strains within a single person). of HIV. Being infected with a different strain (reinfection or superinfection) can limit your treatment options. Speak to your doctor or AIDS council or PLHIV [21]Person (or people) Living with HIV. This term is now preferred over the older PLWHA. organisation for more information.