South Florida seeing an uptick in HIV diagnoses among people 50 and older
Editor's note: This story was reported with the support of a journalism fellowship from The Gerontological Society of America, the Journalists Network on Generations and the Silver Century Foundation.
After Earvin “Magic” Johnson received an HIV-positive diagnosis in 1991, he made an announcement in a room full of sports reporters that people remember to this day.
"Because of the HIV virus that I have obtained, I will have to retire from the Lakers," Johnson said. That press conference is included in an Apple TV+ documentary series coming out on April 22. At the time, Johnson clarified he had the virus, not AIDS — a disease that may result because of HIV. "I plan on going on living for a long time, bugging you guys like I always have, so you'll see me around," he said.
Fortunately, at 62, Johnson has now been alive more than three decades since that day. Today, he continues to raise awareness, combat persistent stigma and help others age with the virus by talking about testing and treatment. He's especially concerned about the impact of the virus on Black and Latinx residents of the U.S.
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In February, Johnson came to Florida for a town hall discussion about HIV (the human immunodeficiency virus) prevention and care.
"What I’m hoping is that those who are living with HIV can be like myself," he told News 4 in Jacksonville. "I’ve been blessed. Thirty years this year."
Clear Health Alliance, a Medicaid specialty program for people in Florida who have HIV and AIDS, organized the event with Johnson. Most members in this plan are between 46 and 64.
Testing for HIV dropped a lot during the pandemic, so state data on new infections are likely an undercount. Still, health officials in South Florida are monitoring a worrisome upward trend in HIV diagnoses among people 50 and older.
In this 2020 report from the Florida Department of Health, the state wrote that the number of new HIV diagnoses over the past five years decreased except among two age groups: people 30 to 39 years old (8% increase) and people who are 50 and older (7% increase).
Whether a person contracted the virus when they were younger and have been in treatment for years, or are testing positive for HIV after they turn 50, it's possible to live into old age with HIV.
"There’s nothing magic about the medications that [Johnson's] on. It's the same medications that someone on Medicaid has access to," said Alina Orozco, a Miami-based director of the Medicaid plan that organized the roundtable with Johnson. She says in order to get the treatment that helps people live into old age with HIV, people have to know they need it.
"A lot of providers don’t necessarily think someone in their 50s or 60s is somebody at risk and they don’t always think to test," Orozco said. "This is an illness that can affect anyone at any point. The crucial thing about testing and knowing someone's status is the ability, then, to link them to care."
Orozco pointed out that ageism in healthcare is one factor. Another is that older people don't see themselves as at risk.
"A lot of these are among men who have sex with men. Some of these are actually among women," said Luigi Ferrer, the health education supervisor at the Florida Department of Health in Miami-Dade County who oversees HIV education. "After 50, they are not concerned about becoming pregnant any more. They're not using safer sex practices. What we've seen is that the percent of diagnoses are going up."
The Florida Department of Health in Palm Beach County is also seeing a rate increase among people 50 and older.
"Why do you use condoms? To avoid pregnancy," said Dr. Alina Alonso, the director of the Florida Department of Health in Palm Beach County, during a press conference focused on the rate increase among women 50 and older, echoing Ferrer's point. "If I’m 50 I don’t have to worry about getting pregnant."
Dr. Casey Messer, the HIV and AIDS programs manager at Palm Beach County Community Services, said the county needs to look into how it communicates with this age group.
"We have to do a better job of tailoring our messaging to that population," he said.
Dr. Mark Brennan-Ing gives talks on sexual health to community groups. They said the message works when it's straightforward.
"It doesn't matter what your age is," Brennan-Ing said. "If you're having sex and it's not protected, you could be at risk for HIV."
Brennan-Ing researches chronic illness and psychosocial issues in older adults with HIV and older sexual and gender minority adults, and is a director at the Brookdale Center for Healthy Aging at Hunter College in New York City.
"I tell people I scare the pants right back on them because they are sexually active," they continued. "No one's talking to them about their sexual health, and the ones who are sexually active do want to talk about it and they want information. They're just looking shocked when I tell them, 'You could it be at risk for HIV. You can't tell by looking at your partner whether they're HIV-positive or not.'"
Brennan-Ing pointed to an ad campaign in New York City with the slogan: “Age is not a condom." The campaign was developed by the AIDS Community Research Initiative of America, or ACRIA, and designed by Andy Chen.
"We had posters up all over the city of older adults, older adults of color, raising awareness around HIV. Information about where to get tested. Information around prevention," Brennan-Ing said.
"If [people older than 50] do present with symptoms of HIV, the physician may not think, 'Oh, maybe it's HIV, maybe I should run an HIV test,'" Brennan-Ing continued. "Even in places like New York, where we're supposed to have opt-out testing."
By law, health care providers in New York State must offer a voluntary HIV test to all patients aged 13-64.
Here in Fort Lauderdale, Arianna Lint points out that making it to old age also requires the support of a community.
"Mental health is so important for people who are older than 50," said Lint, who founded Arianna’s Center, which connects trans people and people with HIV to the resources they need to live healthy lives — including legal advice, job help and education.
"One of the issues you find with an older population as well — that isn't experienced as much by younger people — is isolation," said Alex Spriggs, Arianna's Center operations manager. "The pandemic has increased that dramatically. People who find themselves in a situation where they test for HIV don’t necessarily have the support network that other people have to help them navigate all of the services. Everybody as we get older, our health needs increase, so there's all sorts of things we're navigating, like diabetes or our blood pressure. So there are more considerations if you get diagnosed when you're older."
But, Spriggs adds, the center connects people to care that an older trans patient will need — like an HIV test administrator who may be Spanish-speaking and trans, too, or a doctor who respects pronouns and name choice.
Lint got diagnosed with HIV in her 30s and thought she had 10 years to live, but with treatment and her trans family in South Florida, she's stayed healthy.
Lint turns 50 this year and is now even able to think about her retirement.
For more information:
Florida HIV/AIDS Hotline
— English 1-800-352-2437
— Spanish 1-800-545-7432
— Haitian Creole 1-800-243-7101
— Hearing/Speech Impaired 1-888-503-7118
— Visit 211 Big Bend or text ‘FLHIV’ or ‘flhiv’ to 898211