June 1, 2007

GRAY AREA

Casanova is ready to educate

Along with the side effects of HIV and antiretrovirals, Housing Works client Ronald Casanova, 62, deals with another chronic condition: getting older. "Everything that heroin didn't let me feel, I'm now feeling," said Casanova, a former drug user who was diagnosed in 1992. "Arthritis, high blood pressure, nerve trouble, you name it. Everything associated with old age I'm experiencing."

Casanova is far from alone. It's estimated that 30 percent of people in New York City living with HIV/AIDS are over 50, but prevention efforts, health care, and social services haven't been targeted at the demographic. That's why City Councilwoman Maria del Carmen Arroyo is proposing that the city budget include $1 million for HIV/AIDS prevention and treatment programs aimed at older New Yorkers. The funds would bring HIV/AIDS education to senior citizen centers, train health care providers to treat older people with HIV/AIDS and facilitate collaboration between health care providers and groups that serve people with HIV/AIDS and the elderly.

"Older New Yorkers are proud of the fact that they're sexually active, but they're engaging in activities that put them at risk," said Arroyo, chairperson of the City Council Aging Committee. Arroyo's passion for fighting the AIDS epidemic comes from personal experience. Nineteen years ago her sister died of AIDS, leaving behind two young children. Though the youngest is now 21, Arroyo continues to value the importance of HIV/AIDS education and treatment. In June 2006, when the Aging Committee and the Committee on Health held a joint session on HIV in older adults, Arroyo saw the urgency of understanding how the disease affects the elderly.

"When you complicate aging with HIV/AIDS, health care can become costly. Plus we don't know how antiretrovirals affect treatment for problems of aging. We need to begin to shape a set of programs that will address these and other needs," she said. Arroyo's funding proposal sets aside dollars to develop training materials for health care providers about transmission, drug interactions, and comorbidites, such as cardiovascular disease and diabetes. Arroyo is optimistic the funds will be part of the budget on June 30 and then, she said "we will have a celebration on July 1."

One major hurdle in reaching the over-50 set is that docs often don't recognize that their older patients are at risk in the first place. "For a lot of the medical establishment, HIV isn't on their radar when it comes to older people. To make matters worse, older adults themselves often don't believe they're at risk. But the boomers are a different generation. They're sexually active. If there isn't prevention in place there will be a rise in infections," said Akira Ohiso, coordinator of Housing Works' Ryan White Over 50 program, which provides support groups, therapy, medical care and social events. Begun in 2004, the program has grown to serve 52 clients.

A portion of the $1 million in city funds would bring "HIV 101" to 25 senior centers in areas with a high HIV incidence, said Daniel Tietz, executive director of the AIDS Community Research Initiative of America (ACRIA). ACRIA and other groups that helped Arroyo develop the funding proposal want to arm senior center staff with prevention pamphlets and information. In addition, because senior center staffs are typically small and stretched, influential seniors will be trained as peer educators. "You've got the big personalities everyone knows," Tietz said. "We want to train them to learn about the risks of HIV/AIDS so they can share their knowledge with the rest of the community."

Addressing stigma is also an essential piece of the prevention puzzle. "It's important that older folks begin to realize, over time, that there doesn't have to be stigma," said Bobbie Sackman, director of public policy at the Council of Senior Centers and Services. "Right now there's the mentality of, 'What did that person do wrong?' It's addressing issues relating to stigma for HIV that were prevalent 15 or 20 years ago."

Casanova, for one,is happy to help."Outreach by folks like me who are over 50 is something we need to consider," he said. "I'll get out there and talk to people even though I don't like walking because of my neuropathy."

The Housing Works AIDS Issues Update is reported, written and edited by Diana Scholl, David Thorpe, Christine Campbell, terri smith-caronia and Housing Works staff. Send your feedback, leads and story ideas to d.scholl@housingworks.org.

You can reach us by phone at 212-967-1500 x168, by fax at 212-868-4222, and by email at d.scholl@housingworks.org. Housing Works provides housing, advocacy and services to homeless people living with AIDS and HIV. Housing Works is the nation's largest community-based AIDS organization and the nation's largest minority-controlled AIDS organization.

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