African American women over the age of 49 years old are contracting the HIV/AIDS disease at alarming rates, yet little attention is given toward their prevention needs. HIV/AIDS prevention teaching for postmenopausal Black women is imperative to reduce the incidence and the transmission of this disease. Clinicians who provide health services to postmenopausal Black women need to be educated on their HIV risk behaviors.
African American women living in minority communities have an overall rate of disease incidence, prevalence and morbidity as compared with the health status of the general population as it relates to HIV/AIDS. HIV is the fourth leading cause of death among Black women over 49 years old. Between 1988 and 2001 the rate of HIV infection in women ages 50-59 years old rose from 40 percent to 56 percent. In women 60-65 years old, HIV doubled from 24 percent to 53 percent and in women over 65 years old HIV more than tripled from 13 percent to 43 percent.
Stereotyping postmenopausal women as no longer sexually active often leaves them overlooked in HIV/AIDS prevention teaching, clinical trials and research. All registered nurses working in high-risk HIV communities need to be encouraged to include women over 49 years old in their HIV prevention messages.
Surveys reveal that many women over 49 years old do not view themselves as at risk for HIV and therefore do not take necessary precautions to prevent its transmission. Literature also supports that older women are less knowledgeable on how HIV is transmitted.
Vaginal thinning and dryness makes older women particularly susceptible to HIV transmission because of potential skin tears. Psychologically, women who no longer fear pregnancy may be less likely to use condoms and not think of them as a barrier to the HIV virus. Socially, the male/female ratio limits the available men to choose from and some women may engage in high-risk sexual behavior in fear of losing their partner. If they are aware of the necessity of condoms, they may lack the confidence to assert themselves with their partner regarding consistent use.
Consistent condom use may also suffer due to a lack of knowledge or experience in proper use.
Finally, the older male partner may not achieve a full erection until after initiation of coitus, again putting the woman at risk.
Women should know that this is not just a one-way street either; their partner must be involved in practicing safer sex, such as being supportive of consistent condom use. A sense of self-worth and confidence is essential to achieving this. Not only must women patients be made aware that their bodies still face risks during sexual encounters later in life, they need to feel that their bodies are worth protecting.
A health promotion model of HIV prevention teaching needs a psychological foundation that explains risk behaviors and identifies the best methods to bring about a permanent behavior change. Research has demonstrated that prevention programs work. Persons who are HIV-negative but are at high risk for HIV must be continuously educated and supported at different phases of their lives. Health professionals must encourage women to know their HIV status, regardless of age.