The 'Graying' of an Epidemic: Sexual Scripts, Public Health Influences, and the Organizational Impact on HIV/AIDS Education and Prevention for Older Adults in the Midwest

Abstract

Older adults' sexual health is becoming an increasingly important component of healthy aging in the wake of the HIV/AIDS epidemic and rising infection rates among this age cohort. However, research reveals that this population is often left out of HIV/AIDS public health policy and prevention education. This project uses qualitative methodology to analyze the possible social factors for this omission. To do this, I performed 31 interviews with key personnel at HIV/AIDS service organizations and state-level policymakers in four states in the Midwest. In addition, I conducted an in-depth organizational analysis of an AIDS service organization in one Midwestern state, undertook a content analysis of key funding and policy documents, and collected U.S. national and regional data on infection rates, risk behaviors, and other contributing factors to the rise of HIV/AIDS risk and infections among the older adult population. From the beginning of the epidemic in 1981, the seemingly disproportionate impact that HIV/AIDS had on specific segments of the population resulted in moral judgment of those who were infected. The association of HIV/AIDS with specific groups seen as being "high risk" resulted in certain segments of the population, such as older adults, being considered as low-risk for contracting the virus despite exhibiting high-risk behaviors. The responsibility of a national public health crisis fell squarely on the shoulders of community-based AIDS service organizations who received little fiscal support. The result was gaps in prevention education to certain segments of the population. The increase of HIV/AIDS diagnoses in the older adult population has ignited the need to understand the reasons why older adults have been omitted from HIV/AIDS policy. I examined the social forces that influence HIV/AIDS policy at the national, state, and community level. My findings reveal that HIV/AIDS policy at the national level influences the type of health promotion being done at the state and community levels. AIDS service organizations are held responsible for this national public health care crisis with too little funding. As a result, these organizations are not able to reach every at-risk group, including older adults.