Older HIV-Positive Adults in Xiangxi, China: Infection Modes and Associated Risk Factors

Objective: An unusual increase in HIV/AIDS cases among rural older adults was reported between 2005 and 2008 in Xiangxi Prefecture, Hunan Province. We explored the reasons for this increase and suggested preventive measures for the future control of HIV infection in this population. Methods: A cross-sectional study was conducted using an HIV/AIDS registry in Hunan Province, China, to explore the likely transmission mode and risk factors of HIV/AIDS among older adults. The data were collected by face-to-face interview. Results: A total of 80 participants including 5 couples were interviewed. Among them, 46 (57.5%) participants were male and 34 (42.5%) were female. Of 46 male HIV-positive participants, 45 (97.8%) reported to have sexual intercourse with commercial sex workers. None of the female HIV-positive participants reported to have engaged in commercial sex activities. Among 46 male participants' spouses. 71.7% of them had received HIV testing and 48.5% were HIV-positive. Among 34 female participants' spouses, 92.2% of them had received HIV testing and 87.1% were HIV-positive. Ninety-seven percent of the participants reported never using condoms during sexual intercourse with their marital partners or commercial sex workers before knowing their HIV status. Eighty-two percent of participants did not know that condoms could prevent HIV/AIDS/STIs. Conclusion: Chinese older adults are an underappreciated at-risk population for HIV/AIDS. The likely transmission mode of HIV/AIDS among rural older adults was unprotected sex. The HIV/AIDS/STIs knowledge among this population is very limited.