“People over 50 don’t know about the new ways to prevent HIV”

Sidaction’s campaigns are generally focused on teenagers and young adults. Why did you target the over 50s this year?

The reasons are primarily epidemiological. Since the beginning of the epidemic, we know that the majority of people who discover their HIV status are aged between 25 and 49 on average. Although this group is clearly the majority in terms of discoveries of seropositivity, we have observed a drop over the past 10 years, from 70% to 60%, with a parallel increase for the other age groups. And that is precisely what is attracting our attention today. Among the new diagnoses, the youngest represent around 15%, a figure that has been stable for several years, while the proportion of people over 50, after stabilizing around 20%, has started to increase again for three years. This is the reason why we are now seeking to know the profile of these people, in order to know how to act to reverse the trend. This will of course go through our annual campaign, but also through actions that will target this age group more specifically.

How do you explain this increase among those aged 50 and over?

Exactly, that’s the whole problem, for now we have trouble explaining it. However, we can make assumptions, and what I have noticed for a long time now is that basically HIV is considered as an old disease for young people, and as a disease of young people for old people. These two extreme segments, the youngest and the oldest, are those who feel the least concerned about HIV. But it is very difficult to say anything for the simple and good reason that we do not know the profile of these people aged 50 and over, and we hope to know more with the next health watch figures.

After years of invisibility in the media, the over 50s free themselves from many clichés, including that of not being sexually active… The fact of having forgotten, or ignored, this fact could have played a role in not targeting them earlier?

It’s entirely possible. As I said previously, there are epidemiological reasons, since we addressed ourselves in a privileged way to 25-49 year olds, the most affected, in our major campaigns. But if we dwell on our last survey, we learn for example that the peak of sexual activity for people aged 50 to 79 is around 55-59, and that was indeed off the radar.

The survey also tells us that among the 14% of single people aged 50 to 79 who are sexually active, one in two does not protect themselves. How to explain that this population, although well informed about HIV/AIDS, takes such risks?

Through the discussions that I can have with doctors, these are very variable situations. In the end, we always come back to the fact that there is no typical profile, and this is undoubtedly the complexity. Last week, I was told, for example, of a 60-year-old woman who, after a marital breakdown, met a new partner, and discovered her HIV status a few years after the start of this new relationship. His new companion was probably unaware that he was HIV-positive himself… If I am giving you this example, it is because we are also probably dealing with people who have been in a relationship for a very long time, and who no longer necessarily have, after 10, 20, or 30 years of relationship, the reflex of the condom, and this even if they were perfectly informed before. There is also perhaps for this generation the fear of the gaze of the other when proposing the condom, the fear of being taken for a person with promiscuous morals… All these judgments around the use of the condom could also play a role.

Can the other means of prevention in this case be more beneficial to this age group?

This is another problem, because unfortunately those over 50 do not know the new means of prevention. For a long time, we only had condoms, but today there is, for example, PrEP (Pre-Exposure Prophylaxis, editor’s note), which consists of taking a treatment, either continuously or before and after intercourse. sex, and which is an extremely effective means of prevention. We asked people over 50 about this, and very few of them are aware of this new means of prevention.

The question of screening also arises among those over 50, with only 13% of sexually active single people having had a screening in the last twelve months. How to remedy this finding?

We really need to carry out targeted campaigns, aimed precisely at this age group on screening, which is indeed a central point. Its very important. It is well known today that HIV is transmitted by people who, for the most part, are unaware that they are carriers of the virus. Screening is therefore clearly the cornerstone of prevention, with a double impact. First of all, there is an individual benefit, since with the quality of the treatments we now have, the earlier we are screened, the better we will live, and for as long as HIV-negative people. Then there is a collective benefit, because today when you are a carrier of HIV and you take treatment, you do not transmit the virus. There would therefore also be a benefit on the dynamics of the epidemic if people who contract HIV were treated as soon as possible. To come back to those over 50, there is the view of the other that must also be taken into account, especially since we are still in a society which tends to consider that after 50 is like asexual; which is obviously absolutely not the case. Attitudes unfortunately evolve much less quickly than realities.

Improved treatment now makes it possible to live longer… Can we speak of a perverse effect, which would result in a certain negligence or carelessness with regard to HIV?

It is difficult to answer this question without carrying out targeted surveys, since it is on a case-by-case basis. But it must be said that the representations around HIV are very ambivalent, because many people say to themselves that it is a chronic disease, neither more nor less, whereas the impact on the Social plans. The enormous difficulty today is living with HIV socially, it’s very complicated. It is also very complicated to announce that one is HIV-positive, whether to family, partner, friends, or at work. There is still a lot of discrimination, both in the medical field and in the social sphere, so I don’t think there is more recklessness or negligence in response to improved treatments. Even less among those over 50, moreover, because the questions of death and illness are more present for this age group, not to mention this social impact which is not negligible. You should know that there are associations that welcome people for whom they are the one and only interlocutors on HIV, because the people concerned have not spoken about it to anyone else. And that is very heavy to carry.

Sidaction called on Lio, Dave, and Partenaire Particulier, among others, for this new campaign based on emotion, more than on the shocking messages generally addressed to the youngest. Why this choice ?

Emotion is quite simply an excellent vector. We have all danced to the hits of the 1980s, which ultimately accompany us over the years. This can only mobilize, attract attention, and touch the public, and even more the target of this campaign. It’s a nice and fun way to get the attention of people over 50. Especially since the artists were kind enough to rewrite the lyrics of their own hits to highlight the means of prevention against HIV, including PrEP and condoms. It is not necessarily by scaring people that we attract their attention.