One More Taboo
March 29, 2007By Suzanne Braun Levine In 1984, when my brother came down with the mysterious disease that came to be called AIDS, the diagnosis was a death sentence; today it is a disconcerting and traumatic, but not fatal, surprise. Thanks to a miraculous cocktail of medications, countless Americans are living with the disease with few symptoms and tolerable side effects. Many others are also living with the disease, but they are undiagnosed and therefore untreated. And a surprising number of them are women over 50—women like me. The heterosexual transmission rate of HIV has doubled in the last ten years. Ten percent of the new infections occur in people over 50. These statistics come from an article in the April issue of POZ, the 13-year-old magazine for people with HIV/AIDS. The editor, Regan Hofmann, a gorgeous 39-year-old blond from New Jersey horse country, is herself HIV positive—the result of an ill-fated relationship with a totally respectable man she would “date without hesitation today.” In lectures around the country she speaks of the double trauma of finding out that she is HIV positive and telling her friends, family and finally the public. She worried that some of her friends wouldn’t be able to accept her as someone who would spend the rest of her life with those “shameful” initials attached to her identity; she worried that when she told prospective sexual partners, they would be turned off and run away; she worried about how the folks back in sedate New Jersey would respond. In some cases the worries were well-founded, but for the most part she found first incredulity and ultimately compassionate support. Sometimes her mother, Nancy Cosentino, an equally stunning woman in her early sixties, is in the audience and adds her perspective. She talks about how hard it was for her to accept the news and to share it with her friends. They were sympathetic about the fact that her daughter was very sick, but they had no point of reference for the disease. It was a taboo subject that had no place in their world. Nancy herself had never participated in a conversation about AIDS—as it pertained to women, especially middle class women—and didn’t know where to begin. Devotion to her daughter was where she began. And together they are humanizing the issue for everyone who will listen to them. In my generation, safe sex meant birth-control, which was first the diaphragm and then the Pill. By the time AIDS came along, many of us were in settled relationships and had no occasion to use a condom. As we move into menopause, we assume that we don’t need to “use anything,” and those of us who are divorced or widowed have enough problems getting back into the social swim to even think about learning to use a condom—let alone asking a man if he is HIV positive. According to the POZ article, “even women as young as 35 to 54 were much less likely to ask about their partner’s sexual and drug use history than women 20 to 34.” All of the above is very risky behavior. Menopause causes dryness in the vaginal walls, which can be damaged during intercourse, making it more possible for the virus to enter the woman’s body. A new sex life with new partners creates multiple opportunities for infection. Viagra has enlarged the pool of candidates with a past—from the Midlife Stud to the retirement community lothario so common that he is known as a “Condo Romeo.” Who knew? Like many of us, Nancy had never discussed sex, let alone safe sex or HIV infection, with her doctor—only 38% of women over fifty in a recent study had. Women my age may have doctors who are younger than we are. They can be as embarrassed discussing sex with someone who could be their mother as we are raising the subject with them, even if they believe that anyone over fifty actually has sex. Many doctors are as ill-informed as we are. Mine is a generation that shattered just about every taboo we could find. Now there’s one more—the HIV conversation.