New treats and challenges

I tested positive for HIV in 1990. I was 29 then; I’m 61 now. For the past 15 years or so, health professionals have been paying a lot of attention to the aging of the HIV population. They often discuss the so-called “graying of HIV” in terms of people over 50. We seem to like slicing history up into quarter-century segments. We get excited about 25th anniversaries, 50th anniversaries, 100th anniversaries. But as I slide into my sixties, I realize that 50 and 60 are at least as different as horses and zebras, if not zebras and giraffes. How does this apply to the impact of HIV on the sex, love, and dating lives of people over 60? I’m learning by doing, asking other people what their experience is, and sharing what I learn with you. 

I’m finding that HIV holds new treats in store for us as we exit our 50s. For example, in recent months I had cataract surgery on both eyes. The doctor says I’m a bit young for cataracts, but a bunch of studies have observed a greater risk of cataract surgery among people with HIV. Some of these studies suggest that the increased risk may be related to long-term antiretroviral therapy (ART). Even if that’s the case, you’ll get no complaints from me—ART saved my life, and cataract surgery has rendered me glasses-free for the first time in 50 years, so it’s kind of a win-win. Not sure the vision issue is really related to sex, love, and dating, although some may think I look more handsome without glasses, and it’s a sterling example of how HIV may affect us in surprising ways as we transition into retirement savings, Medicare, and Social Security territory. 

But while health and medical issues are certainly relevant, what grabs my attention the most are issues of sex, love, dating, and other forms of intimate relationships with HIV over 60. I will fess up to the fact that this topic interests me right now because I’m in the process of divorcing from my husband, to whom I got married in 2004, and with whom I’ve been in a relationship since 2000. Now the divorce plunges me back into the deep end of the dating pool for the first time in over 20 years. 

Because our relationship was always open, I’ve been, if not dating with HIV, at least hooking up with HIV without interruption (more or less, with the exception of one jealous boyfriend and one outright monogamous boyfriend in the 1990s) for some 30 years now. Right off the bat, I’ll say things are much easier for me now, HIV-wise, than they were in 1990. I don’t need to go into a lot of tedious details here about what those early days were like. Suffice it to say that living with HIV back then sharply curtailed your sex and dating options (unless you were comfortable with lying, whether by commission or omission, about your HIV status). Those were the days of dates getting up from the table and walking out on you in the middle of dinner when you disclosed your HIV status. And by “you,” I mean me, but I know I was not alone in having that rather devastating experience. 

The great equalizers, so to speak, have been ART and PrEP (pre-exposure prophylaxis, or medication an HIV-negative person takes to prevent acquiring HIV through sex). In 2016, a group of activists started a campaign to spread the word that a person with HIV who is on ART, and whose virus has been undetectable for at least six months, cannot transmit HIV sexually. They sloganized this concept as “Undetectable Equals Untransmittable” (U=U). I suspect the first population to feel the impact of U=U was people in serodiscordant relationships; that is, where one person is HIV-positive and the other is not (in a sense, both partners in such a relationship are “living with HIV”). Understanding U=U provided a sound scientific and medical basis for serodiscordant couples to stop using condoms with each other if that was their mutual preference. In my case, my HIV-negative husband and I were able to begin having unprotected sex safely. When he and I first met, in 2000, he had friends who urged him to dump me because of my HIV status. His parents were particularly concerned, and not unreasonably. He assured me I was not “getting rid of him” that easily—but in fact, we continued to use condoms for many years.

Beyond the context of couples in committed relationships, however, I don’t think HIV-negative people—for the most part—were banging down the doors to have condomless sex with HIV-positive partners. In my experience, however, PrEP did in fact change that reality, and dramatically so. While the first PrEP medication was approved in the United States in 2012, it took a number of years for PrEP to really catch on. You may remember the years of Truvada shaming, when some gay men referred to PrEP takers as “Truvada whores,” equating the prevention strategy with sexual indiscretion, aka being a slut. Once U=U took off, however, there was an interesting synergy between U=U and PrEP. A whole new population emerged, particularly among gay men and people who are trans (women and men alike), comprised of those who were living with HIV and undetectable on ART, and those who were HIV-negative and on PrEP, who were interested in interacting sexually with each other.

‘If 61 years of life has been any indication, I have a fairly indomitable spirit, and I love to love love.’


This advent of U=U and PrEP has created a context in which sex, love, and dating with HIV over 60 today has a much greater range of possibilities, and even probabilities, than it had even 10 years ago. And this is where I get into potentially salacious territory about my own experience as an older—perhaps I may be so bold as to say “much older”—sexually and emotionally available gay man living with HIV over 60. To put it bluntly, and with no scientific or medical data to back me up (well, not that I’ve looked for any, frankly), I have found that older gay men—particularly older gay bottoms—who are living with HIV and are undetectable on ART, are veritable magnets for younger gay men—particularly younger gay tops and vers tops—who are HIV-negative and on PrEP. Many of the latter appear to believe that many of the former “make better bottoms,” and I am certainly not going to argue with them on that score. (I told you this might get salacious.)

But enough of my own personal cotton candy factory. I want to turn now to some stories I’ve uncovered, on social media and via email, of people with HIV over 60 who are in various kinds of sex, love, and dating situations. This is the “community perspectives” part of our program, you might say. Communications have been lightly edited. 

A friend of mine in New England, age 62, tells me she has been monogamous and married for some 25 years: I probably acquired HIV around 1984. I was diagnosed somewhere around 1986 or 1987. It took a decade to become an AIDS patient (my lowest CD4 count was 7). I struggled with notions of love and sex way back then, thinking I would never have them in my life again. Turns out I did find a love and sexual relationship, with someone nine years my junior, and HIV-negative. And then later, love and sex and pregnancy, a baby, marriage, and another baby, all in the relationship with my husband (seven years older than me), also HIV-negative. So now we are an old married couple with an almost empty nest (younger son has another year of college to go), and to be extremely honest, we have practically no sex life anymore. Just cuddling. And I am happy with that—in the real world. Of course, in fantasy land, I would be wildly sexual with someone and enjoying that…but I am very rooted in what is actually happening, rather than pining for something else.

This advent of U=U and PrEP has created a context in which sex, love, and dating with HIV over 60 today has a much greater range of possibilities, and even probabilities, than it had even 10 years ago.

I love that story. And this from a longtime HIV/AIDS activist in Brookfield, Illinois, Roy Ferguson, who wrote to me about his life with his partner, Michael Winkfield, also an activist: I am 70 and my partner is 63. Both U.S. military veterans. I did two and a half years before I was discharged in 1972. He was 21 years in the Air Force, 14 years in NATO, and was discharged in 1997. We have been together four and a half years. Both of us are HIV-positive. Roy is on the board of directors of AIDS Foundation Chicago. 

I posted a call for comments in a number of HIV/AIDS-related Facebook groups. A woman in the United Kingdom commented: Well, I have no experience about dating over 60 with HIV, but lots about love and sex, as I am 69 and still with the person who passed HIV to me (he is 70). We have been together since 1985, long before HIV came into the picture. So, no experience with dating at all, but certainly about love and the challenges and sex, now and then.

Not everyone has such a rosy story to share. A man in Mendocino, California, commented: I’m 60. I’ve been positive for 25 or more years. I find dating to be extremely difficult at 60. It’s difficult to meet anybody, and when you do, in today’s world they’re often a long way away. You start off with some long-distance relationship that generally ends up going nowhere. I find it difficult to relate to people that I am positive, as they tend to shy away after that. And loneliness is such a drag.

The comment by the Facebook group member in Mendocino reminds us of the dark places where we may find ourselves more frequently as we get older. A 2017 study by researchers at the University of California San Francisco (UCSF) participating in the HIV Over 60 Cohort Study found a significantly greater burden of psychiatric symptoms among people with HIV over 60 compared to their HIV-negative peers in the same age group. These symptoms included more frequent agitation, depression, anxiety, apathy, irritability, and nighttime behavior disturbances. 

As we wrap up here, I can bring this part of the story back to my own experience. Yes, I like to focus on what a boy magnet I am, and on my gratitude for all the young gay men who are HIV-negative on PrEP and think that my status as a gay man over 60 with undetectable HIV makes me a “better bottom.” But if the truth be told, facing my divorce as who and what I am is freaking me out. I make my living as a freelance writer. I sing for my supper, as it were. No biweekly paycheck. No employer paying for my health insurance or contributing to my retirement savings. None of that is HIV-specific, of course; but add HIV to the mix, and the whole thing becomes that much scarier. 

I’ve spent 30 years telling people I was fine. In the early ’90s, the founding chairman of amfAR (The Foundation for AIDS Research) Mathilde Krim herself told me that if people like me could hang on just a few years more, there would be lifesaving medications for us. And of course, she was true to her word. Even during COVID, when friends urged me to go to the front of the line for vaccinations or boosters, I would patiently explain that I don’t get to go to the front of the line, because I am not immunocompromised. I have lots and lots of very healthy, happy, functional T cells. And yet….

I wrote a poem once about getting blood drawn for my labs. It starts: 

On command I make a fist, hold it

like a little boy facing off

against the schoolyard bully

(holding back hot tears—ain’t affeared o’ nuthin’)

That poem refers to the “before times”—before effective ART. The speaker in the poem, who is of course an “autofictional” me, is in fact afraid. And now, I’m afraid again. I can’t quite believe this run of amazing luck and incredible good fortune is going to continue indefinitely. I mean, HIV or no HIV, I’m going to be 70 (if I’m lucky), and then (if I’m lucky) 80, and then… who knows? 

I guess what I’m saying is that, thanks to the miracles of modern science and medicine, people living with HIV over 60 face the same basic dilemma as everyone else over 60—impending mortality, time’s winged chariot hurrying near. But again, those pesky cataracts: concrete evidence that maybe my friends who tell me to get to the front of the line because I’m immune compromised—maybe they have a point. I hate to admit it, I hate to acknowledge it, I hate to accept it—but that doesn’t make it any less true.

Have I strayed too far from the topic of sex, love, and dating? Wasn’t this supposed to be a fun, funny, lighthearted piece about how aging with HIV these days is barely any different from aging without HIV? Well, if so, maybe I’ve failed. Wouldn’t be the first time. Perhaps I’m just breaking through my denial. I’m pretty sure there is sex, love, and dating in my future. Well, there’s already sex; I mean, a leopard can’t change its spots that easily, right? As for dating…do people actually date anymore? I have Netflix; let’s just get some takeout and chill. As for love, well, I’m going through a rough patch, but if 61 years of life has been any indication, I have a fairly indomitable spirit, and I love to love love. Maybe this time it will be somebody my own age for a change. Maybe somebody with HIV for a change. Although younger is fine, and older is fine, and HIV-negative is fine. It’s all fine. Maybe that’s the real bottom line. As I like to say, as long as you’re alive, everything’s going to be fine, one way or another…isn’t it?

Michael Broder is a gay, white, poz, Jewish, male, late-Boomer Brooklyn native, born 1961. Columbia undergrad, MFA in creative writing from NYU, and PhD in classics from the CUNY Graduate Center. He tested HIV-positive in 1990, and started doing AIDS-related journalism while collecting unemployment insurance in 1991. He lives in Bedford-Stuyvesant, Brooklyn with numerous houseplants and three feral backyard cats.