Despite substantial progress in slowing the epidemic among substance-abusing populations, new cases of HIV increasingly can be attributed directly to injecting drug use through contaminated needles or indirectly through sexual transmission. While many studies examine factors related to drug use practices and AIDS among young and middle-aged substance abusers, few studies have considered how HIV is contracted or experienced among older addicts. This article reviews what is known about HIV and older substance abusers with special emphasis on the age-related factors that shape the experience of AIDS for this population. Next, drawing on findings from the Partners in Community Health Project, the analysis explores factors that underlie older injectors' and other substance abusers' risk for HIV. Next, issues related to treatment of older HIV-positive injecting drug users are explored. Finally, priorities for future research are identified.
Get full access to this article
View all access options for this article.
References
1.
Agar, Michael
. 1973. Ripping and Running: A Formal Ethnography of Urban Heroin Addiction. New York: Seminar Press.
2.
Allers, Christopher T.1990. "AIDS and the Older Adult."The Gerontologist30:405-407.
3.
Anderson, G.1994. "HIV Prevention and Older People."SIECUS Report23 (2): 18-20.
4.
Arkinson, R. M.
and L. L Kofoed. 1984. "Substance Use and Abuse in Old Age."Substance Abuse5:30-42.
5.
Besch, C. Lynn
. 1995. "Compliance in Clinical Trials."AIDS9:1-10.
6.
Capel, William C.
and Lafy G. Peppers. 1978. "The Aging Addict: A Longitudinal Study of Known Abusers."Addictive Diseases: An International Journal3 (3): 389-403.
7.
Chaisson, Richard E.
, Jeanne C. Keruly, Sharon McAvinue, Joel E. Gallant, and Richard D. Moore. 1996. "Effects of an Incentive and Education Program on Return Rates for PPD Test Reading in Patients with HIV Infection."Journal of Acquired Immune Deficiency Syndrome and Human Retrovirology11:455-459.
8.
Chenitz, W. Carole
, Sally Salisbury, and Joyce Takano Stone. 1990. "Drug Misuse and Abuse in the Elderly."Issues in Mental Health Nursing11:1-16.
9.
Chesney, Margaret
and S. Folkman. 1994. "Psychological Impact of HIV Disease and Implications for Intervention."Psychiatric Clinics of North America17:163-182.
10.
Clement, M.
and M. Hollander. 1995. "Initial Evaluation of and Health Care Maintenance for the HIV-Infected Adult" Pp. 130-140 in The Medical Management ofAIDS. Philadelphia: W. B. Saunders.
11.
Courtwright, David
, Joseph Herman, and Don Des Jarlais. 1989. Addicts Who Survived: An Oral History of Narcotic Use in America, 1923-1965. Knoxville: University of Tennessee Press.
12.
Elwood, Wellman N.1995. "Lipstick, Needle, and Company: A Case Study of the Structure of a Bridge Group in Houston, Texas."Connections18 (1):46-57.
13.
Faltz, Barbara G.1992. "Coping With AIDS and Substance Abuse." Pp. 137-150 in Living and Dying With AIDS, edited by Paul I. Ahmed. New York: Plenem.
14.
Faupel, Charles E.1991. Shooting Dope: Career Patterns of Hard-Core Heroin Users. Gainesville: University of Florida Press.
15.
Hays, Robert B.
, Sarah Chauncey, and Linda A. Tobey. 1990. "The Social Networks of Gay.Men with AIDS."Journal of Community Psychology18:374-385.
16.
Hershow, Ron
, A. Rahimian, A. Jimenez, W. Johnson, N. Prachand, and W. W. Wiebel. 1997. "The Role of Indigenous Outreach Workers in the Contact Investigation of Active Tuberculosis Cases Among Substance Users in Chicago." Presented at the American Public Health Association annual meeting, Indianapolis.
17.
Holland, J.
, C. Ramayanoglu, S. Scott, S. Sharpe, and R. Thompson. 1992. "Risk, Power, and the Possibility of Pleasure: Young Women and Safer Sex."AIDS Care4 (3):273-283.
18.
Hu, D. J.
, R. Byers Jr., P. L. Fleming, and J. W. Wards. 1995. "Characteristics of Persons with Late AIDS Diagnosis in the United States."American Journal of Preventive Medicine11 (2):114-119.
19.
Inciardi, James A.1992. The War on Drugs H. Mountain View, CA: Mayfield.
20.
Inciardi, James A.
, Dorothy Lockwood, and Anne E. Pottieger. 1993. Women and Crack-Cocaine. New York: Macmillan.
21.
Justice, Amy C.
and Sharon Weissman. 1998. "The Survival Experience of Older and Younger Adults With AIDS: Is There a Growing Gap in Survival?"Research on Aging20 (6): 665-685.
22.
Koester, Stephen
and Judith Schwartz. 1993. "Crack, Gangs, Sex, and Powerlessness: A View From Denver." Pp. 187-203 in Crack Pipe as Pimp, edited by Mitchell S. Ratner. New York: Lexington Books.
23.
Lawson, Ann W.1989. "Substance Abuse Problems of the Elderly: Considerations for Treatment and Prevention." Pp. 95-113 in Alcoholism and Substance Abuse in Special Populations, edited by Gary W. Lawson and Ann W. Lawson. New York: Aspen.
24.
Levy, Judith A.
1992. "Intergenerational Social Support for Active Drug Abusers." Presented at the International Sociological Association Mid-Congress XII, Stockholm, Sweden.
25.
Levy, Judith A..1993. "Sexuality and Aging." Pp. 115-124 in Principles of Geriatric Medicine & Gerntology, 3d ed., edited by William R. Hazzard, Edwin L Gierman, John P. Blass, Walter H. Ettinger, and Jeffrey B. Halter. New York: McGraw-Hill.
26.
Levy, Judith A.
and Daniel J. Amick. 1993. "Older Street Addicts: Surviving Life in the Life." Presented at the International Institute of Sociology, 31st International Congress, Sorbonne, Paris.
27.
Levy, Judith A.
, Charles Gallmeier, and W. Wayne Wiebel. 1995. "The Outreach Assisted Peer-Support Model for Controlling Drug Dependency."Journal of Drug Issues25 (3): 507-529.
28.
Martin, John L.
and Carole S. Vance. 1984. "Behavioral and Psychological Factors in AIDS: Methodological and Substantive Issues."American Psychologist39:1303-1308.
29.
McCormick, Wayne C.
and Robert W. Wood. 1992. "Clinical Decisions in the Care of Elderly Persons With AIDS."Journal of the American Geriatrics Society40:917-921.
30.
Morse, E.
, P. Simon, M. Coburn, N. Hyslop, D. Greenspan, and P. Balson. 1991. "Determinants of Subject Compliance Within an Anti-HIV Drug Protocol."Social Science and Medicine32:547-563.
31.
Neaigus, A.
, S. R. Friedman, R. Curtis, and Don C. Des Jarlais. 1994. "The Relevance of Drug Injectors, Social Networks, and Risk Networks for Understanding and Preventing HIV Infection."Social Science and Medicine38 (1):67-78.
32.
Ouellet, Lawrence
, Matta Kelly, Andrea Coward, and Wayne Wiebel. 1995. "Developing Community Resources for a Stigmatized Population." Pp. 207-230 in Advances in Medical Sociology, vol. 6, edited by Gary L. Albrecht. Greenwich, CT: JAI.
33.
Platt, Jerome J.1986. Heroin Addiction: Theory, Research and Treatment. Malabar, FL: Krieger.
34.
Prohaska, Thomas
, Gary L. Albrecht, Judith A. Levy, Noreen Sugrue, and Joung-Hwa Kim. 1990. "Determinants of Self-Perceived Risk for AIDS."Journal of Health and Social Behavior31:384-394.
35.
Seeman, T. E.
, G. A. Kaplan, L. Knudsen, R. Cohen, and J. Guralnik. 1987. "Social Network Tlies and Mortality Among the Elderly in the Alameda County Study."American Journal of Epidemiology126 (4):714-723.
36.
Schuckit, Marc A.1987. 'The Geriatric Alcoholism and Drug Abuse."The Gerontologist17 (2): 168-174.
37.
Singh, N.
, CL. Squier, C. Sivek, M. Wagener, M. H. Nguyen, and V. L. Yu. 1996. "Determinants of Compliance with Antiretroviral Therapy in Patients with Human Immunodoficiency Virus: Prospective Assessment with Implications for Enhancing Compliance."AIDS Care8 (3):261-269.
38.
Solomon, Liza
, David Vlahov, Jacqueline Astemborski, Noya Galai, Neil M. H. Graham, and Kenrad E. Nelson. 1995. "Factors Associated With Initiation of Zidovudine in a Cohort of Injection Drug Users."Journal of Drug Issues25 (1): 225-233.
39.
Sutin, David G.
, David N. Rose, Michael Mulvihill, and Brian Taylor. 1993. "Survival of Elderly Patients With Transfusion-Related Acquired Immunodeficiency Syndrome."Journal of the American Geriatrics Society41:214-216.
40.
Sutter, Alan
. 1966. "The World of the Righteous Dope Fiend."Issues in Crimonology2 (2): 177-222.
41.
Vella, Stefano
, Marina Giuliano, Marco Floridia, Antonio Chiesi, Carlo Tomino, Angela Seeber, Sabrina Barcherini, Raffaella Bucciardini, and Sergio Mariotti. 1995. 'Effect of Sex, Age and Transmission Category on the Progression to AIDS and Survival of Zidovudine-Treated Symptomatic Patients."AIDS9 (1): 51-56.
42.
Wallace, Jeffrey I.
, Douglas Paauw, and David H. Spach. 1993. "HIV Infection in Older Patients: When to Suspect the Unexpected."Geriatrics48 (6): 61-70.
43.
Watters, John K.1993. "The Significance of Sampling and Understanding Hidden Populations." Pp. 13-21 in AIDS and Community-Based Drug Intervention Programs, edited by G. Fisher and Richard H. Needle. New York: Haworth.
44.
Williams, Mark L.
and Frederick R. Snyder. 1993. "Drug use, Sexual Behaviors, Risk of HIV Infection and Age Difference Among Injection Drug Users nNot in Treatment." Pp. 297-312 in Handbook on Risk of AIDS, edited by Barry S. Brown and George M. Beschner. Westport, CT: Greenwood.
45.
Williams, Mark L.
, Robert T. Trotter II, Zhangquing Zhou, Harvey A. Siegal, Rafaela R. Robles, and Adelbert Jones. 1995. "An Investigation of the HIV Risk Behaviors of Drug Use Networks."Connections18 (1): 58-72.
46.
Winick, Charles
. 1962. "Maturing Out of Narcotic Addiction."Bulletin on Narcotics, January-March, 1-7.
47.
Wolfe, Hannah
, Michael Marmot, Robert Maslansky, Stuart Nichols, Michael Simberkoff, Don Des Jarlais, and Andrew Moss. 1995. "Tuberculosis Knowledge Among New York Injection Drug Users."American Journal of Public Health85 (7): 985-988.
48.
Zablotsky, Diane L.1998. "Overlooked, Ignored, and Forgotten: Older Women at Risk for HIV Infection and AIDS."Research on Aging20 (6): 760-775.
49.
Zehner, M. A.
and J. Lewis. 1984. "Homosexuality and Alcoholism: Social and Developmental Perspectives." Pp. 75 in Homosexuality and Social Work, edited by Robert Schoenberg and Richard S. Goldberg with David A. Shore. New York: Haworth.
50.
Zumwalt, S.
and R. Schmidt. 1989. "AIDS & Aging: The Role of Nutrition."Generations13 (4): 77-79.
