HIV in US Prisons

Of the 2.2 million people serving time in US prisons, around 1.5 % of those are living with HIV or AIDS. That number is about four times higher than the infection rate of HIV in the general population. Studies show that most HIV positive inmates are infected before they enter prison. Nevertheless, prison environments offer many opportunities to spread HIV. High risk behaviors such as injecting drugs, tattooing, body piercing and unprotected sex (consensual and rape) are not uncommon in a prison setting.

To give you an idea of the situation, I found a CDC (Center of Disease Control) study carried out in a Georgia State Prison between 1992 and 2005. It showed that 54 inmates (45 cases and 9 control persons) reported having male-male sex while in prison. Some 35 persons (78 %) of the case inmates and four (44%) of the nine control inmates reported no male-male sex after the first six months following incarceration. Among those who reported any male-male sex, 39 said they had consensual sex with other inmates. They exchanged sex for food, cigarettes, money, etc. Rape was also reported. When consensual sex occurred 34 (30%) reported using condoms or other improvised barrier methods (such as a rubber or plastic glove). In “exchange sex,” 21 % said they used improvised methods, but no condoms. No protection was used during rape.*

What has been done in the US about this situation?

Several bills have been introduced to attack this growing problem. It's been clear that the prison authorities must ensure a safe and humane treatment of prisoners who are HIV positive or are living with AIDS. Congresswoman Barbara Lee (CA) has introduced H.R 3053 – to Repeal Existing Policies that Encourage and Allow Legal HIV Discrimination Act (REPEAL HIV Discrimination ACT). And Congresswoman Maxine Waters (CA) has introduced H.R 3547, the Stop AIDS in Prison Act. This legislation calls for a comprehensive policy to provide HIV-testing, treatment and prevention measures for inmates in federal prisons and upon their reentry into the community. It would also require prisons to test inmates upon intake and offer counseling. It also requires frequent HIV/AIDS educational programs for all inmates.

Some state prisons have HIV positive people in separate facilities, arguing that such separation allows them to focus on medical care. The HIV positive inmates and HIV negative inmates mix for education, vocational training, religious and other prison programs. But is such segregation of HIV positive inmates really the solution?

As a matter of fact, separate facilities may well increase the already existing stigma. I believe that separate facilities may well be inhumane and degrading and may violate international law. Even if you are in prison, you should have the right to privacy. It should be the citizen’s right to decide whether to tell others of his/her health status. Laws and regulations that exist regarding HIV status should be the same in prison as in free society.

On the other hand, confidentiality of medical information in a prison setting is hard to maintain. Persons other than of medical staff members may handle medical records. Once such information is released, it travels fast. It has been argued that prisoners have a greater need for privacy than those outside because they live in a closed community where violence is common. Also, if prisons fail to keep medical records confidential, inmates might choose not to get tested, to avoid being victims of this double-sided problem. Prison officials also use HIV tests results to make decisions about housing (separate housing as one option in some prisons), work assignments, and visiting privileges. It's been common to ban HIV positive inmates from kitchen work.

Many inmates report difficulties getting the right medications and at the right time, or at all. To solve this problem, separate facilities might be a solution. Nevertheless, is it necessary to put HIV- positive prisoners in a separate facility simply to assure that they get the right medications at the right time? I am sure the prison system can do better than that. Besides, keeping people in different facilities does not reduce the spread of other sexually transmitted, opportunistic, and blood-borne infections. Such policies do not prevent transmission by inmates who are unaware that they are infected or by HIV-infected correction staff. There is no available data that show the effectiveness of separate housing for HIV positive inmates as an HIV – prevention strategy.

A better solution alongside education and volunteer testing would be to make condoms available in prisons and assure confidential patient care. Such a policy would focus on educating prisoners about how the virus is contracted. And it would demonstrate that HIV-positive people CAN work in a kitchen!

Sanna Klemetti

smklemetti@gmail.com

Learn more and see references at:

*http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5515a1.htm

http://www.aclu.org/hiv-aids-prisoners-rights/sentenced-stigma-segregation-hiv-positive-prisoners-alabama-and-south-caro

Dying in Prison - The US' Massive Prison Population is Getting Older

 Prisons across the USA are dealing with an aging group of people. According to a Human Rights Watch study made in 2010, some 26,000 inmates in the USA were 65 and older, and this trend is growing. A new report from the American Civil Liberties Union estimates that by 2030, the over -55 group will number more than 400,000. This projection amounts to about a third of the overall prison population.

More and more older women and men are dying in prison of natural causes. Some grow old and die in prison and some enter prison in such a poor health that they will die before they complete their sentence. According to the National Institute of Corrections, prisoners age 50 and older are considered “elderly” or “aging” due to unhealthy conditions prior to and during incarceration. A study by Brie Williams and Rita Albraldes published as a chapter in the book Growing older: challenges of Prison and Reentry for the Aging Population, found that in addition to the chronic diseases that increase with age, older offenders have problems such as paraplegia because of the legacy of gunshot wounds. Many have advanced liver disease, renal disease, or hepatitis. Still others suffer from HIV-AIDS, and many more endure the effects of drug and alcohol abuse. Living under prison conditions, they are more likely to get pneumonia and flu.

Cells and dormitories are starting to fill up with old, often sick, men and women. They get around in wheelchairs and walkers. They fill the prisons, assisted living wings and hospices faster than the state and federal government can build them. And since they will probably die in prison, they also fill up the mortuaries and graveyards.

Passing on in a Prison

Some prisons have created hospices to respond to the emotional as well as physical needs of the dying. The rules about visitors are usually more relaxed, so that family members can sit at their relative's bedside seven days a week and are permitted to hug and touch their loved one. The “staff” in a hospices are other volunteer inmates who complete a 50 hour training, as well as ongoing training as the need arises. These volunteers will read, pray and write letters for the dying; they also assist the nurses with certain tasks such as preparing baths and changing diapers.

Sadly, even though attempts to try to deal with this growing challenge, it is still far from well working. Most of the time, the care the aging inmate receives is grossly inadequate and very expensive. For the first time some states are considering releasing terminally ill and mentally ill prisoners before they complete their sentence. To me this seems like a good idea.

Compassionate Release?

Compassionate release is a legal system that grants inmates early release from prison sentences on special grounds such as terminal illness or a child in the community with an urgent need for his or her incarcerated guardian. Compassionate release can be mandated by the courts or by Internal Corrections Authorities. Unlike parole, compassionate release is not based on a prisoner's behavior or sentencing, but on medical or humanitarian changes in the prisoner's situation. Why should we let people out from prison?

It is unnecessary to keep the old incarcerated, since there is evidence that demonstrates that recidivism drops dramatically with age. For example, in New York, only 7% of prisoners released from prison at ages 50-64 returned to prison for new convictions within three years. That number drops to 4% for prisoners age 65 and older. In contrast, this figure is 16% for prisoners released at age 49 and younger. Further, the majority of aging prisoners are not incarcerated for murder, but are in prison for low-level crimes. in fact, many aging prisoners are incarcerated for nonviolent crimes.

Keeping people in prison is very expensive. The US spends approximately $77 billion annually to run the penal system. The incarcerated aging prisoners cost far more than younger ones. Specifically, it costs $34,135 per year to house an average prisoner, but it costs $68,270 per year to house a prisoner age 50 and older.

US Federal sentencing laws has been very harsh for a generation. Compassionate release is a humane and practical program and it saves money. Yet, it has not been used very much. In a lot of cases, prisoners and their families don't even know about this program.

Sanna Klemetti

sm.klemetti@gmail.com

For references and to learn more please read:

http://www.aclu.org/files/assets/elderlyprisonreport_20120613_1.pdf

Growingolder: challenges of Prison and Reentry for the Aging Population

Aging in Prison

Recently I attended the monthly general meeting of the New York NGO Committee on Ageing. The topic was “Aging in Prison – a Human Rights Issue.” Two academics who have specialized on treatment of US prisoners presented some of their research. They were:

Tina Maschi, PhD, LCSW, ACSW, who is now Associate Professor at Fordham University Graduate School of Social Services (FUGGS); she’s also a Social Fellow at the New York Academy of Medicine, a Research Scholar at the Ravazzin Center on Aging, and Coordinator for the FUGGS Human Rights and Social Justice sequence. The second speaker, Deborah Viola, PhD., is Associate Professor and Associate Director, Doctoral Program, Department of Health Policy & Management at New York Medical College, and Research Scholar at the Center for Long Term Care Research & Policy.

General Facts

The US population makes up about 5 percent of the world’s population. About 10 million people are imprisoned world-wide. Surprisingly, 25 percent of those are “doing time” are held in US prisons. Among them, 16 percent of the 10 million are 60 years and older. The US exceeds all nations in the number of old people incarcerated in its prisons. At present, the older population is the most rapidly growing group in US prisons. In fact, the number of older prisoners is growing faster than the number of older persons in the US population. In the US, 756 human beings out of every 100.000 people are incarcerated.

Why are there so many people in US prisons?

One would think since the US has the largest prison population in the world that the nation must be home to very dangerous criminals who everyone would agree are “bad” people. But wait a minute, are they?

About three decades ago the US introduced a “tough on crime” policy. State and federal legislators adopted laws that increased the likelihood and length of prison sentences, by including mandatory minimum sentences and three strikes laws. It seems a bit strange that while the crime rate had declined since the 1980's; nevertheless the US prison population grew six-fold.

It is very interesting that the US has privately owned prisons. The two largest private prison companies combined to bring in close to $3,000, 000, 000 in revenue in 2010. Earlier in the 1980's, there were no privately owned prisons in the US. Since then the number of incarcerated people has exploded. It does not take a genius to see what is going on here.

Last year the largest private prison in the US, Corrections Corporation of America (CCA), received $ 74 million of taxpayers’ money to run immigration detention centers. There are numerous reports on human rights’ abuses in these private prisons. For example, when auditors visited one private prison in Texas, they “got so much fecal matter on their shoes they had to wipe their feet off on the grass outside.” The prisoners were literally living in their own excrement. To make a phone call to a lawyer or loved ones, the CCA charges its inmates $ 5 per minute, yet the prison only pays inmates who work at the facility $1 per day. To me, it looks like the more people the “justice system” can put behind bars, the more money the private prisons will make.

A lot of people go to US prisons because of drug crimes. Examining who actually goes to prison because of a drug crime speaks very loud. About 14 million whites and 2.6 million Afro-Americans report using an illicit drug. While five times as many whites are using drugs as African Americans, yet African Americas are sent to prison for drug offenses at 10 times the rate of whites. African Americans serve virtually as much time in prison for a drug offense (58.7 months) as whites do for a violent offense (61.7 months). Surely this is not “equal treatment under the law.” One out of every 12 Afro-American men of working age is in prison. These statistics tell us that if you commit a drug crime and are not white, you will go to prison. If you are white, it is considered a public health problem.

What are the problems facing an older population behind bars?

Prisons in general are designed for the young and able-bodied. For example, when people grow older they have different medical and health needs than the young. Older persons are more likely to develop disabilities that require the use of assistive devices such as glasses, hearing aids, wheelchairs, walkers and canes. As in the community, the elderly in prison suffer from falls, which contribute to hip fractures and high health costs. Even if these conditions are provided for, many elder inmates are confined in facilities that cannot meet the structural or programmatic needs of mobility-impaired persons. Because of their higher rates of illness and impairments, older prisoners incur medical costs that are three to nine times higher than those of younger prisoners. In general a younger prisoner costs about $22.000 per year while an older person can cost as much as $65,000 per year.

It is also documented that the older prisoners “age” about 15 years faster than people who are not incarcerated.

Sooner or later, one of two things will happen to an aging prisoner. Either he/she will die in prison, or will be released. Neither of these alternatives has gained that much attention. Reentry into society is very difficult for any former prisoner. Older persons face additional challenges. Older women and men find it extremely hard to find work, housing and transportation, as well as necessary medical and mental healthcare. Some have the assistance from former friends and family, but many have lost contact with their families because of the length of time incarcerated or the nature of their crimes.

As the number of older prisoners increases, so too does the number of men and women dying of natural causes behind bars.

For references and more information please visit:

Human Rights Watch's report “Old Behind Bars”

Statistics 

Sanna Klemetti

s.klemetti@globalaging.org

How Does Depression Wreck Your Life?

All too often stereotypes cast older persons as “grumpy.” Many people think that being down and depressed is normal in old age. Attention!

It is NOT a natural part of aging. 

Depression can happen to anyone at any age and is common among older adults and seniors. Some 15 out of 100 adults over the age of 65 suffer from depression in the US. Who are these older adults and why do so many of them suffering from depression? Studies show that the disorder affects people in nursing homes and hospitals in even greater numbers. Recognizing depression among old persons is not always easy. Depressed elders may find it difficult to describe their feelings. Many fear revealing their sadness since they may associate it with being “crazy” or lacking self-control. In the youth of today’s elders, they learned that depression often was associated with being “crazy” or weak-minded. Today, we know hat depression is a fully treatable medical or biological illness.

The Movie Grumpy Old Men

Aging, HIV and Depression

Experts have discovered a link between HIV-positive older adults and depression. To find out more about this development, I met up with Stephen Karpiak to talk about HIV positive older adults and seniors. A PhD, Karpiak joined ACRIA (AIDS Community Research of America) in 2002, as Assistant Director of Research. He served as primary investigator at the agency's new behavioral research effort, including conducting groundbreaking Research on Older Adults with HIV(ROAH) study. Earlier, he had worked for over 20 years at Columbia University's Medical School as a research scientist in neurobiology and immunology. Karpiak also started a Phoenix, Arizona, project to provide housing for homeless people living with HIV/AIDS. Dr. Karpiak has documented over 250 articles in scientific journals and books, and has been holding lectures all over the world.

 Dr. Karpiak

Karpiak told me that the ROAH goal focused on understanding the situation of those over the age of 50 who are living with HIV. ROAH sought answers to identify their psycho-social needs and determine how to support them most effectively to live longer, healthier and happier lives. ROAH assessed a 1,000-person cohort in New York City, examining a comprehensive array of issues, including health status, stigma, depression, social networks, spirituality, sexual behavior, and substance abuse.

ROAH showed that stigma, isolation and depression are the major problems for this group. The stigma against HIV/AIDS and is usually associated with homophobia, racism, ageism, etc.

ROAH demonstrated that by repressing the immune system, depression may render people more vulnerable to infectious diseases. Stress and depression have a harmful effect on cellular immunity, including those aspects of the immune system affected by HIV. Body cell mass depletion is associated with significant increase in fatigue, global distress and depressive symptoms, and reduced life satisfaction. Elevated symptoms of depression associated with a faster progression to AIDS and a higher risk of mortality.

Stigma often leads to isolation, depression and loneliness. Older HIV positive adults who are depressed are more likely to have financial problems, have fewer people to turn to for support, lack critical HIV-related information, live alone, have thoughts of suicide, and experience greater levels of stigma related to HIV and aging as compared to older adults who are not depressed. Depression may also stop persons from getting treated, avoiding doctor visits, social activities and other relationships. ROAH found that aging HIV-positive adults experience significant levels of depression, at a rate at least five times higher than the general New York City population.

Dr. Karpiak and Sanna Klemetti

Solutions?

I asked Dr. Karpiak what has or can be done about this situation. As a matter of fact, successful projects exist. One example is the MacArthur Foundation Model that expects participants to make one phone call every week to ask the HIV affected person how he/she is doing. The effect of this simple and effective program has been great. Another ACRIA project is The Go 4 Part Program, funded by Mac AIDS fund. It's a two day HIV – aging training program. Around 25 educators visit about two cities per year, to bring AIDS, health and aging organizations together to educate them about these issues. They also introduce ideas on how to reduce the problems. They usually invite one person from the meetings to New York to see the work carried out at ACRIA.

More about ROAH

Sanna Klemetti

s.klemetti@globalaging.org

Should You Have to Reveal your HIV Status?

Living with HIV, whether you just learned about your status or have known about it for some time, there will be situations in your life when you will have to decide whether or not to disclose your HIV status. Who do you need to tell? Is there anyone you must tell? A spouse, a partner, or someone you have been dating? What about previous sex partners? In fact there are laws in the US that regulate some of these situations.

Legal Disclosure

If you are tested HIV positive, the clinic will report the result to the local Health Department, so that the public health officials can monitor what's happening with the HIV epidemic in your city and state. Your state health department will then remove all your personal information and send the information to the US Centers for Disease Control and Prevention (CDC).

In many cases sharing your HIV status is a personal choice. But many States have laws that require you to tell specific people about your HIV status. The laws may differ from State to State. Some have partner-notification laws, and some states have established criminal penalties for knowingly exposing or transmitting HIV to someone else. Some States also have a law called “duty to warn.” This law is somewhat complicated since physicians have a legal and ethical obligation to maintain confidentiality regarding their communication with patients. So, a complicated ethical and legal question arises when the HIV infected person deliberately avoids reporting to the interested individuals about the possibility of HIV transmission. This law allows the clinical staff to notify a “third party” if they know that a person has a significant risk for exposure to HIV from a person that staff members know is infected with HIV.

HIV Criminalization Laws

HIV criminalization laws began in 1990 when the federal Ryan White CARE Act passed. The laws were meant to protect the public, to prevent cases involving someone with HIV knowingly exposing others to the virus. Thirteen States have laws against HIV positive people spitting on or biting someone. Some States address needle sharing or blood, organ or semen donation. For example, in the State of Iowa, failing to disclose a HIV – positive status can bring a 25 year long sentence and a lifelong sex offender status. The official charge “criminal transmission of HIV” is the same as a class B felony in Iowa. Other crimes in this category include manslaughter, kidnapping, drug crimes and robbery. There have been cases when a prosecutor has won cases even when a condom has been used and the victim did not contract the virus. To date, HIV-specific criminal charges have been filed more than 1.000 times in the US alone.

Act Up/Queerocracy March

Better Solutions?

It's clear most of these laws are outdated and were adopted when knowledge about HIV was very limited. Today we know that HIV is not transmitted through saliva but there are still people in prison for committing this “crime.”

I checked in with Sean Strub, HIV positive founder of SERO Project, a non-profit human rights organization combating HIV- related stigma. He argues that HIV criminalization laws is the biggest driver of stigma in US society. Sean says that such laws are creating HIV-specific statues in some states and territories, thereby creating a “viral underclass” in the law, making the rights of those with HIV inferior to others. I asked Sean what laws regarding a person’s HIV status should look like?

“I don't think there should be laws mandating disclosure of one's HIV status. There are assault statutes in most every jurisdiction that can be used when someone is found to have a malicious intent to infect someone. Otherwise, HIV status is private and personal information, like all medical information.”

I also wanted to know if it's true that there are still HIV positive people in prison for spitting or biting another human being. “Yes, there certainly are. I received a letter yesterday from Willy Campbell, who is serving 35 years in a Texas prison for spitting at a cop. The Center for HIV Law & Policy found about 25% of cases in recent years were for spitting, biting or scratching, behaviors that are unpleasant and, depending on the circumstances, might be appropriate for some charge, but they don't transmit HIV. Years in prison and sex offender registration are not appropriate penalties”.

It has been acknowledged that these laws are outdated and may even backfire. For instance, the Obama administration's 2010 AIDS initiative argued that the laws “may make people less willing to disclose their status by making people feel at even greater risk of discrimination. Iowa Senator Matt McCoy, a Democrat, called the laws retaliatory. “This is medieval and it goes back to treating HIV as if it was leprosy and basically we need to repeal these laws.” He has introduced a bill to repeal and modernize the law to include HIV in the contagious disease section of the Iowa code. Unfortunately, his proposed legislation did not make it out of the subcommittee.

“I don't think HIV criminalization laws are the right answer to end HIV and AIDS. A bigger problem is that people who do have HIV and don't know about it, Sean told me. “More transmissions in the US. come from people who do not know their HIV status because they haven't been tested. I am guessing that is true to an even greater extent outside of the US but I don't have data.”

Sean Strub

Maybe more focus should be put on encouraging people to take responsibility to get tested? We should make testing more accessible and easier than it is today. It is not the job of everyone else to protect you. It's up to you to make sure you know your status and it's up to you to make sure you protect yourself. Don't get me wrong; it's never okay for someone knowledgeably to put another person at risk. There needs to be a balance between honesty and privacy.

To read more about testing yourself, please read this previous article :

Do You Know Your Status?

Sanna Klemetti 

s.klemetti@globalaging.org

UNAIDS

Michael Sidibé, UNAIDS Executive Director

Most people have heard about UNAIDS. But who are they? What do they actually do? How do they operate? Do they make a difference?

When and How?

In the early days of HIVAIDS’ infection in many parts of the world, the UN Economic and Social Council launched UNAIDS to respond worldwide in January 1996. A Programme Coordinating Board with representatives of 22 governments from all geographic regions and of several Cosponsors led the response. They include UNHCR (The UN Refugee Agency), UNICEF (United Nations Children's Fund), WFP (World Food Programme), UNDP (United Nations Development Programme), UNFPA (United Nations Population Fund), UNODC (United Nations Office on Drugs and Crime), ILO (The International Labour Organization), UNESCO (United Nations Educational, Scientific and Cultural Organization), WHO (World Health Organization and The World Bank.

There are also five more seats without voting rights reserved for a balanced mix of non-governmental organizations, including people living with the virus. This makes UNAIDS the only UN institution to have non-governmental organization participation on its governing board.

The UNAIDS headquarters is in Genève, Switzerland. There are 7 regional offices and over 80 countries around the world. The first Executive Director was Peter Piot. On 1 January 2009 Michael Sidibé became the new first Executive Director.

Every so often UNAIDS organizes High Level meetings to evaluate the work that has been done in the different regions, countries and research groups. At these meetings new goals are agreed upon and organized. These can be both small and big milestones. In New York City at the 2011 High Level Meeting on AIDS, the governing members adopted a new Political Declaration adopted a declaration and included new commitments and challenging new targets which UNAIDS hopes will re-invigorate the AIDS response.

Funding

Voluntary contributions from governments, foundations, corporations, private groups and individuals support UNIAIDS. The USA, the Netherlands, Norway, Japan, the United Kingdom and Sweden are the largest donors. UNAIDS also receives funds from 25 other countries. The global economy always affects HIV/AIDS funding, prevention and treatment. For instance, during the 2008 – 2009 global economic crises, donor spending decreased in low and middle-income countries. UNAIDS reported in 2009 that the economic downturn has negatively impacted AIDS programs and the situation continues to get worse.

UNAIDS Goals and Achievements

The UNAIDS’ mission is to guide, strengthen and support worldwide efforts to fight the HIV/AIDS epidemic. It aims to prevent the spread of HIV, provide care and support for those who are infected and affected by the disease, reduce the vulnerability of individuals and communities to HIV/AIDS and ease the socioeconomic and human impact of the epidemic.

Since the start of UNAIDS millions of lives have been saved. UNAIDS has assisted countries to achieve results. For example, 3.3 million people can now access HIV treatment through UNAIDS. Antiretroviral therapy can prevent new HIV infections, preserve health, and lengthen life expectancy. Starting HIV treatment early in its infection, helps prevent HIV transmission. This shows the importance of access to HIV treatment.

UNAIDS estimates 7,000 newly HIV-infected people each day. Preventing the spread of HIV remains one of UNAIDS’ main goals through national, regional and international approaches to stop its deadly progress.

Year 2015

2015 will be a very important year for UNAIDS. Here are the goals that UNAIDS has set up for 2015:

* Universal access to antiretroviral therapy for people living with HIV who are eligible for treatment; sexual transmission of HIV reduced by half, including among young people, men who have sex with men and transmission in the context of sex work.

* TB deaths among people living with HIV reduced by half.

* HIV-specific needs of women and girls are addressed in at least half of all national HIV responses.

*UN member states has also committed to expanding access to treatment for 15 million people by 2015.

To read all of the goals for 2015 please visit:

http://www.unaids.org/en/media/unaids/contentassets/documents/unaidspublication/2010/JC2034_UNAIDS_Strategy_en.pdf

There are some potential blocks to achieving these goals. The biggest one is money. International assistance for the AIDS response dropped in 2011 for the first time since 2001. During the 2011 High Level Meeting on AIDS states agreed to increase AIDS- related spending to reach between US$ 22 billion and US$24 billion in low- and middle- income countries by 2015.

What else could be done?

The work UNAIDS is doing is very important. There are a few things, I think, must be improved. First, their website is accessible in four different languages, and those are, English, French, Spanish and Russian. This means that the website is available in four out of the six official UN languages. Why have they chosen not to add Mandarin and Arabic? Both are official UN languages. If Global Action on Aging can manage to provide articles in all official UN languages, why can’t the richly funded UNAIDS do the same?

Second, UNAIDS provides detailed research from all over the world, about all regions and countries. But the UNAIDS lacks information about older adults and seniors living with HIV and AIDS. UNAIDS speaks about prevention for different groups, but it never mentions the aging population in any country. Its statistics are not very clear when it reaches the higher ages. UNAIDS provides data for adults aged 15 to 49 years, or children aged 0 – 14 living with HIV. HIV/AIDS and older adults/seniors is definitely a growing public health problem (and a personal tragedy) that deserves more attention.

UNAIDS has accomplished a lot. To reach its final goal, “Zero New Infections, Zero AIDS-related Deaths and Zero Discrimination,” its work must continue. We must make certain make all countries continue to recognize the importance of fighting the HIV epidemic. The population must recognize the importance of fighting the HIV epidemic. We have come very far since the beginning of HIV/AIDS. We are not yet done. We must not give up the fight.