They’re aging, they’re vulnerable, and they’re being overlooked. Older adults in Africa are increasingly affected by HIV—but prevention campaigns still fixate on the young.
Key Points at a Glance
- The number of HIV-positive adults over 50 in Africa is rapidly increasing
- Current prevention campaigns rarely target this age group
- Low testing rates and stigma delay diagnosis and treatment
- Older women—especially widows—face the highest risk
- Long-term data sheds light on this neglected population
HIV doesn’t discriminate by age—but public health messaging often does. In sub-Saharan Africa, a quiet epidemic is unfolding among older adults, yet prevention and treatment efforts continue to focus primarily on youth. A new study published in The Lancet Healthy Longevity reveals that adults over 50 now have HIV prevalence rates equal to or higher than those of younger people. And by 2040, one in four people living with HIV in Africa will be over 50.
This demographic shift challenges long-standing stereotypes about who acquires HIV. “We often think of HIV as a disease of younger people,” says Dr. Luicer Olubayo of the Sydney Brenner Institute for Molecular Bioscience at Wits University. “That perception means older adults are often excluded from interventions—despite being at growing risk.”
Between 2000 and 2016, the number of HIV-positive adults aged 50 and older in sub-Saharan Africa doubled. Yet public health campaigns and HIV surveys continue to center on younger populations. This leaves glaring gaps in our understanding of the epidemic among older people—gaps that carry real consequences. Uptake of HIV testing among the elderly is low, diagnosis is delayed, and stigma remains a formidable barrier.
“Older adults frequently underestimate their risk of contracting HIV,” says Associate Professor F. Xavier Gómez-Olivé of the MRC/Wits-Agincourt Research Unit. This mindset can lead to dangerous outcomes, especially when layered with social stigma and a reluctance to seek testing. The result? Missed opportunities for early diagnosis, delayed treatment, and poorer health outcomes.
Stigma is especially potent in this age group. Many older people face not only ageism but also the shame and misunderstanding surrounding HIV, which affects their mental health and access to care. Dr. Olubayo emphasizes the importance of tailored strategies that directly address older adults’ realities—socially, culturally, and medically.
Long-term data collected from urban Kenya and both urban and rural South Africa provide rare insight into this growing crisis. The Africa Wits-INDEPTH Partnership for Genomic Research (AWI-Gen) studied adults over 40 across four countries over nearly a decade. The results paint a complex picture, showing how education, gender, income, and location all influence HIV risk in older populations.
One of the most vulnerable groups? Widowed women. In the study, they had the highest rate of HIV at 30.8%. These women often lost partners to HIV and may engage in transactional sex or lack the power to negotiate condom use. Limited education and economic hardship only compound the risk.
Importantly, the study’s authors advocate integrating HIV treatment into broader chronic illness care. Older adults in Africa are also contending with rising rates of hypertension, diabetes, and obesity. Managing HIV alongside other non-communicable diseases isn’t just logical—it’s essential.
As the continent ages, the approach to HIV must evolve. This means shifting the narrative, expanding testing, improving access to PrEP, and designing campaigns that resonate with older audiences. It also means recognizing that age does not shield against vulnerability. Quite the opposite—it can amplify it.
The message is clear: fighting HIV in Africa requires widening the lens. It’s time to bring older adults into the center of the conversation—before another generation is left behind.
Source: Wits University
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