Question: My second husband and I were married 12 years ago. We are in our late 70’s. He was diagnosed with dementia last year. Although I suffer from congestive heart failure, rheumatoid arthritis, and high blood pressure, I have been committed to caring for him at home. Recent events, however, make this difficult. He has been impotent since shortly after we married, but his doctor prescribed Viagra several months ago, and now I am at my wit’s end. While his memory has been failing in other ways, my husband has now become obsessed with having sex every day. This is both stressful and painful to me, and is totally out of character for him.

I have not been able to convince him that I have physical problems, and he now thinks that I am seeing another man and don’t love him. This has led to continuous arguments. While my husband is a wonderful man, I feel abused emotionally and physically, and don't know what to do about it. My children tell me to leave him, but I am financially dependent.

Answer: The natural bodily changes that take place with aging, coupled with your own physical problems, lead us to conclude that your husband’s physician may not have considered the effects on you when he prescribed this medication for your husband.

If you have not spoken to his physician, we would suggest that you do so – that is, assuming that he or she will talk to you without your husband’s permission given the new HIPAA confidentiality requirements. If your husband has not signed a HIPAA release, we suggest that you make an appointment for your husband and try to discuss this issue with his physician in your husband’s presence. Communication in this fashion may be difficult given your husband’s dementia, however. Another possible way to let his doctor know that this problem exists would be to ask your physician to contact your husband’s physician about your difficulties. We would assume that given the circumstances you describe, this issue should be resolved with their assistance.

If not, given your husband’s dementia, counseling would probably be a waste of time. We also believe that interference by children or other third parties would be counterproductive, given the very personal nature of the problem and your husband’s dementia. But it would not hurt to ask a qualified counselor whether there are ways in which to deal with this issue.

If all else fails, we suggest that you contact an experienced matrimonial lawyer in your area who will be able to fill you in on your rights and what you may expect in your state. We believe that your physician will support the proposition that given the bodily changes that accompany aging and your own physical problems, sexual relations could well be considered to be abuse under these circumstances.

But there are always risks when it comes to litigation, and it should be the last resort. We hope your difficulties can be resolved otherwise.

Question: I have been reading your column for years and have found it to be of great help to me. Now I want to give you some information that I hope you will pass on to your readers. I am 65 years of age, widowed for ten years, and am HIV-positive as a result of unprotected sex. I learned about my disease when I applied for insurance. I had always associated this disease with drug use, blood transfusions, and the younger generation. I never gave it a second thought. I was wrong. If you choose to pass this on to your readers as a warning, please don’t use my name.

Answer: There is no question but that seniors are seldom questioned about their sexual history by their physicians and for the most part, consider warnings about the dangers of unprotected sex as being inapplicable to them.

Based on statistics from the Centers for Disease Control and Prevention, the number of Americans over age 50 who suffer from AIDS has increased significantly during the 1990’s and into the 21st century. Because HIV has been considered a disease of the young, prevention programs for seniors have been lacking. It is anticipated that the problem will get worse as Baby Boomers come of age because older women are likely to be divorced or widowed. And, because many have gone through menopause, they are more likely to engage in unprotected sex because they can’t get pregnant. Furthermore, with the advent of Viagra, having sex has returned to the lives of many seniors.