En español | It announced itself among the young. Five otherwise healthy men in Los Angeles had been stricken by a rare, debilitating form of pneumonia. Baffled doctors reported the news in June of 1981, and, soon after, other scientists revealed a medical mystery of their own: young men with a skin cancer usually found among the elderly.
See also: 5 breakthrough AIDS treatments.
Within 18 months, the federal government linked the afflictions to a new disease that it named "acquired immune deficiency syndrome," or AIDS. By 1983, when scientists isolated the human immunodeficiency virus (HIV) as the cause, 1,300 Americans had died — most of them under 40. Thirty years on, though, AIDS is increasingly a disease of older people, who make up the fastest-growing segment of the HIV-positive population. Of the estimated 1.1 million Americans with HIV, some 407,000 are over 50; by 2017, half of the total HIV-positive population will be over 50. New treatments have allowed many patients to live far longer, and far better, than they could have in the early days. But the aging of AIDS is not simply a result of new treatments. Shockingly, one in seven new diagnoses of HIV or AIDS is in a person over 50.
"The burden of this disease is going to be borne out in the older adult," says Stephen Karpiak, Ph.D., of the AIDS Community Research Initiative of America (ACRIA) in New York City. And the health care system will feel its impact. Older people with HIV contract more diseases of aging than their uninfected peers — even when the virus has not progressed far enough to warrant a diagnosis of AIDS. And though HIV is often transmitted by sharing hypodermic needles, older Americans are more likely to get it through unprotected sex. Many think condoms are only for preventing pregnancies — or that a partner over 50 is less likely to have the disease.
Longtime survivors say the graying of AIDS creates a new set of unknowns. "It was like walking into a dark forest," says retired designer Bradford Branch, 59, recalling the early days of the epidemic. "It's kind of like that right now. We're older and HIV-positive, and we have no models for what we're going through." The landscape has changed: HIV/AIDS is not the gay, white disease of yore. It affects more African Americans and Latinos, more straight people, more of the poor.
Still, while people with HIV/AIDS face daunting challenges, they are by and large alert, hopeful — and fully alive. We met several who have confronted the disease and emerged with a clearer sense of what life is all about.