High rates of AIDS-related mortality among older adults in rural Kenya.

BACKGROUND Health challenges faced by older people in developing countries are often neglected amidst a wide range of competing priorities. This is evident in the HIV field where the upper age limit for reporting HIV prevalence remains 49 years. However, the long latency period for HIV infection, and the fact that older people continue to be sexually active, suggests that HIV and AIDS are likely to affect older people. To better understand this, we studied mortality due to AIDS in people aged 50 and older in an area of rural Kenya with high rates of HIV infection. METHODS A community health worker-administered verbal autopsy system was introduced in Nyanza Province, encompassing 63,500 people. Algorithms were used to determine cause of death. RESULTS A total of 1228 deaths were recorded during the study period; 368 deaths occurred in people aged 50 years and older. AIDS was the single most common cause of death, causing 27% of all deaths. AIDS continued to be the main cause of death up to age 70 years, causing 34% of deaths in people aged 50-59 years and 23% of deaths in people aged 60-69 years. CONCLUSIONS AIDS remains the principle cause of death among older people in Nyanza Province in western Kenya up until the age of 70 years. Greater efforts are needed to integrate older people into the HIV response and to better understand the specific vulnerabilities and challenges faced by this group.