At 74, Mzee Juma never imagined HIV would become a part of his life. A father of six and a grandfather of 10, he had always been the one advising his grandchildren about the dangers of risky behaviors, warning them to avoid HIV. “I would sit them down and tell them, ‘Be careful, this disease is real,’” he recalls. But at this age, he was the one to receive the life-altering news: “You are HIV positive.”
For decades, Juma had led a life that many would consider careful and uneventful. The diagnosis came as a shock, not only to him but to his family as well. In Kenya, the focus on HIV prevention has mainly targeted younger people, particularly those between the ages of 15 and 24, with little attention paid to those beyond retirement age. Yet, Mzee Juma’s case reflects a hidden vulnerability among older adults in Kenya, who may live for decades free of the virus but later contract it unexpectedly.
In 2023, nearly 100 Kenyans aged 60 and above contracted HIV, with at least six individuals over the age of 75. According to the National Syndemic Diseases Control Council, these infections are often overlooked in the broader discussion about HIV in Kenya. Many elderly people remain at risk of HIV infection, even in their later years. Juma recalls visiting a clinic in Nairobi, initially seeking treatment for what he thought was a persistent flu and an upset stomach. When nurses suggested an HIV test, he dismissed the idea, laughing it off. “I thought HIV was for young people my children’s generation, not mine.”
This mindset reflects a broader perception that older people are at little to no risk of contracting HIV. However, many older adults begin new relationships in their later years, either after losing a spouse, remarrying, or forming new companionships. In these relationships, they may not use condoms, as concerns about pregnancy are no longer relevant. This can expose them to HIV without their realizing it.
While there is little literature on HIV among older Kenyans, the issue is not unique to Kenya. The U.S. Centers for Disease Control and Prevention (CDC) notes that older people, especially those who test positive for HIV, may have unknowingly lived with the virus for years or even decades. The CDC points out that older adults are often perceived to be at low risk for HIV, which can result in healthcare providers not recommending testing for them. Additionally, symptoms of HIV in older people may be mistaken for age-related conditions, leading to delays in diagnosis.
The CDC also notes that a significant number of older adults are diagnosed with late-stage HIV, which can complicate their treatment and result in worse health outcomes. In the U.S., about 34% of individuals aged 55 and above had late-stage HIV (AIDS) at the time of their diagnosis in 2021. This means many elderly individuals begin their HIV treatment later than younger people, which may lead to more damage to their immune systems.
For elderly Kenyans, the shame and stigma associated with HIV can be particularly overwhelming. Many elderly people, like Juma, feel isolated after their diagnosis. Their families may question how someone of their age could have contracted the virus, and the stigma can prevent many from seeking treatment or support. “For young people, there are support groups and campaigns,” says Nelson Otwoma, executive director of the National Empowerment Network of People Living with HIV/AIDS in Kenya. “But for the elderly, they have no space to talk about their experiences. They suffer in silence, sometimes avoiding treatment altogether because they feel too ashamed to explain their diagnosis.”
Though HIV infections in Kenya have generally decreased since 2013, with a significant drop in the number of new cases, the reality remains that many elderly people are still at risk. While the new HIV infections in Kenya have dropped from 101,560 cases in 2013 to 8,937 in 2023, the experience of Mzee Juma serves as a reminder that HIV knows no age. The journey for older individuals who contract HIV later in life can be a difficult and isolating one, but raising awareness and ensuring access to support services is crucial to reducing the stigma and providing proper care.
