HIV rates are climbing in the over-50s in the UK and across Europe, while the rate of new infections among younger people is dropping, according to new research which warns that the epidemic may be taking a new direction. The study, published in the Lancet HIV journal, from the European Centre for Disease Prevention and Control in Sweden, says that older people are most likely to be infected through heterosexual sex. They are also likely to have more advanced disease – which will be harder to treat and could be life-threatening – when it is finally picked up. The study’s authors suggest that the over-50s may be either complacent or ignorant of the risks of HIV, which has dropped out of the headlines since it became a treatable disease. Their doctors also tend to assume that older people are not running risks through unsafe sex.

The National Aids Trust said in a report in The Guardian that they had been aware of the rising rates in older people in the UK for some time and that action was needed to prevent these infections, such as targeting different age groups – not just the young – with information about their risks and offering HIV tests in places other than sexual health clinics, such as GP surgeries. “In recent years there has been a steady increase in HIV diagnoses amongst people over the age of 50 in the UK, accounting for 9% of new diagnoses in 2006 and 17% in 2015,” said Kat Smithson, director of policy and campaigns. “The trend is not limited to, but is more prominent, in the heterosexual population. This presents a challenge to think about whether our prevention efforts meet the needs of changing demographics.”

Professor Janet Seeley from the London School of Hygiene and Tropical Medicine said that many older people did not think they were running a risk. “The main thing is complacency, and also they are in relationships where pregnancy is not a problem, so contraception isn’t something people consider,” she said. “I think there is very little publicity around HIV in Europe now that prevalence and incidence have gone down.”

The new infections were more often caused by heterosexual sex, she thought, because the gay community was far more aware of the risks. “Men of that particular age have gone through quite a lot themselves,” she said. It would be naive to expect governments to do anything about increasing awareness among the over-50s, given the pressures on health services, she acknowledged, but the study should encourage big campaigning groups – in particular the Terrence Higgins Trust, which had been working on the issue.

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