Women with HIV age with a more complex vulnerability profile than men

Women ageing with HIV have a higher prevalence of frailty than men, despite being younger and having a better immune status. This is demonstrated by a new study from the Over50 cohort of the Fight Infections Foundation, which analyses gender differences associated with ageing among people with HIV.

The research, published in the scientific journal Viruses, analysed 588 people with HIV over the age of 50, of whom 139, or 23.6%, were cisgender women. Participants came from two tertiary hospitals in Spain and were assessed from a comprehensive geriatric perspective, taking into account clinical, functional, cognitive, psychological and social aspects.

The results show significant differences between men and women. Frailty was present in 17% of women, compared with 9% of men, almost twice as high. In addition, women had a higher prevalence of musculoskeletal conditions, 47% compared with 28%, and depressive symptoms, present in 45% of women compared with 30% of men.

More sleep disturbances were also observed among women, 10% compared with 5%, as well as a higher prevalence of cognitive complaints, 23% compared with 11%. In contrast, cardiovascular diseases were more common among men, 48% compared with 35%, as were kidney diseases, 22% compared with 15%.

Ageing with HIV is different for men and women

One of the most relevant aspects of the research is that it shows that frailty does not appear to be associated with exactly the same factors in men and women.

In women, frailty was independently associated with musculoskeletal disease, cognitive impairment, depressive symptoms and malnutrition. In men, however, in addition to factors such as musculoskeletal disease, cognitive impairment and malnutrition, older age was also associated with frailty.

The authors therefore describe a multidimensional vulnerability profile among women, compared with a frailty profile more closely linked to age among men. These results support the need to adapt healthcare by specifically incorporating geriatric, mental and musculoskeletal health.

A specific focus on women ageing with HIV

According to the researchers, ageing among women with HIV remains an area that requires greater attention. The study itself is based on the fact that gender differences in ageing among people with HIV remain poorly characterised and notes that biological, clinical and psychosocial factors may act together in women.

The results therefore reinforce the need to take gender into account when detecting frailty early and addressing ageing among people with HIV, with care that goes beyond controlling the infection itself.

The Over50 cohort, specialising in HIV and ageing

The study, led by Dr Patricia Echeverría, is part of the Over50 cohort, coordinated by Dr Eugènia Negredo and Dr Jordi Puig from the Fight Infections Foundation, and includes people with HIV aged 50 or over receiving care at two tertiary hospitals in Spain.