Women represent approximately 25% of all older adults living with HIV in the United States. Like other older adults, they confront the same challenges of reducing the health and psychosocial impacts aging. Too often, HIV research has disregarded women because men who have sex are most commonly associated with HIV. While there are few significant gender differences, women may have different life experiences living with HIV than men. Clearly women are at increased risk for osteoporosis (see Bone Health Section on this site) and cardiovascular disease. AIDS-related mortality in women is falling but at least one study has determined that women are at a growing risk than men for cardiovascular disease. Older women with HIV may also be at higher risk for obesity due to changes in metabolic processes as well as poor nutrition and inadequate exercise.
PSYCHOSOCIAL ISSUES FOR OLDER WOMEN WITH HIV
Compared to men, women are at increased risk for domestic violence as well as elder abuse (read additional information section). The literature is not conclusive when comparing clinical, behavioral and psychosocial variables among older women with HIV. Some reports show that women tend to be more adherent to ART and have higher rates of viral suppression. They also have higher sustained rates of medical visits. Women are less likely to report having depression, but some studies show they have higher rates of bipolar disorder.
Unlike older men living with HIV, women often had/have the responsibility of raising children. The children create links to family members including grandparents, brothers, sisters, etc. The challenges become further complicated when raising a child who was infected with HIV neonatally. Raising children is a significant stressor as well as a motivator and source of reward. For that reason, women often have relationships with family members. These relationships form part of the basis for their social networks. This becomes a source of informal caregiving as the HIV positive woman ages and their day-to-day care needs increase. The financial demands on older women with HIV may also be greater when they are raising children. Some women may neglect their health as they give priority to their children’s needs.
The sexual health of older women is in part marked by menopause, which may occur a few months earlier in HIV-positive women when compared to their uninfected peers. Some data also show that menopause in HIV-positive women can last longer. Other issues that may negatively impact older women as they age included post-traumatic stress disorder (PTSD. Often this results from sexual assault or other trauma . Finally, the ratio of women to men in communities of color is disadvantageous to women. There are fewer men due to high rates of incarceration and poor access to health care. In order to sustain a long-term relationships, older women may tolerate a partner’s infidelity or lack of commitment to them. Seeking companionship, sexual gratification, and intimacy, older women with HIV may take risks that affect their safety and health.
What you and your doctor can do
Because women may be at greater risk of cardiovascular disease than men, it is important that women discuss the importance of addressing risk factors, such as smoking, high blood pressure and cholesterol. Finally, if you are experiencing symptoms that might suggest depression, it is imperative that you discuss them with your provider so you can be treated if necessary.
What you can do
Lifestyle changes can help reduce risks for cardiovascular disease, osteoporosis, and other health and psychosocial issues associated with aging. Consult those specific sections on this resource site for guidance. Social engagement is an essential element of aging well. Creating and strengthening relationships is critical. That includes reaching out to other women, so they know they are not alone.