study of the relations between psychological, neu­rological, and immunological systems that raise or lower our susceptibility to and ability to recover from disease. The focus of much of this research has been on identifying the psychological triggers that start the process and result in cancer. Two general types of investigations have been conducted (Irwin, 2008): predicting which healthy older adults are likely to eventually get cancer and predicting those who will live longer after being diagnosed with cancer. So far, findings are mixed. Some results show that having a positive attitude and a good social support system predict longer life for middle-aged patients with cancer but not for older ones (Schulz et al., 1996). To make matters more complicated, some evidence suggests that the effects of social support are more important for women than for men. Interestingly, factors such as depression have not yet been shown to have strong effects (Cohen & Herbert, 1996).

AIDS and Older Adults. An increasing number of older adults have AIDS; the Centers for Disease Control and Prevention (2008e) estimate that in the United States roughly 15,000 people over age 65 have AIDS. These statistics include people who con­tracted the human immunodeficiency virus (HIV) during middle age and survived to later life and people who contracted the disease as older adults. Unfortunately, because of the social stereotype that older adults are not sexually active, many physicians do not test older patients; however, as HIV/AIDS rates increase among older adults, the importance of testing is being emphasized (Longo et al., 2008).

Although older men are at higher risk for AIDS, older women also are at significant risk. For men, the most common risk factor is homosexual or bisexual behavior. In contrast, AIDS usually is transmitted to older women through heterosexual contact with infected partners. Older adults may be more susceptible to HIV infection because of the changes in the immune system discussed earlier. For women, the thinning of the vaginal wall with age makes it more likely that it will tear, making it easier for the HIV to enter the bloodstream. Older adults may believe that condom use is no longer necessary, which also raises the risk (Tangredi et al.,

2008) . Once they are infected, the progression from

HIV-positive status to AIDS is more rapid among older adults. Once they are diagnosed with AIDS, older adults’ remaining life span is significantly shorter than it is for newly diagnosed young adults and mortality rates are higher (Emlet & Farkas,

2002) . However, age is not a significant predictor of who will use services from a human service agency (Emlet & Farkas, 2002).

Clearly, older adults need to be educated about their risk for HIV and AIDS, and about the con­tinued need for condom use (Tangredi et al., 2008). Few media stories about the problem focus on older adults, who thus may mistakenly believe they have nothing to worry about. They are less likely to raise the issue with a physician, less likely to be tested, and, if diagnosed, less likely to seek support groups. In short, we need to change the stereotypes about older adults and sexuality and focus on health and prevention.