Photo Credit: Jacob Wackerhausen

Older women with HIV face complex, intersectional challenges that warrant more support, according to a scoping review with input from a patient panel.

Older women with HIV experience complex, intersectional challenges in living with their disease that are specific to their gender and age, underscoring a need for support and services tailored to this population, researchers report in HIV Medicine.

Although social identity is known to play a crucial role in how patients experience disease and receive care, previous research has often overlooked or excluded women older than 50 who have HIV.

“Existing research has underscored the inadequacy of existing policies in addressing the needs of older adults living with HIV,” Kristina Kokorelias, PhD, and colleagues wrote. “Furthering our understanding of the intersectionality of social identities in the context of women aged [50 and older] living with HIV may help inform the development of inclusive policies, advocacy efforts, and health and social care interventions to better care for this aging population.”

Dr. Kokorelias and colleagues performed a systematic scoping review of studies in which older women with HIV made up 50% or more of the population. All studies focused on patients’ experiences related to age in health-specific or social settings. The researchers then synthesized information from the review and presented it to a panel of eight women with HIV aged 50 or older for responses and insights, particularly about contextualizing the findings in real life and ensuring that the review accurately reflected the experiences of this patient group.

Existing Literature on Older Women With HIV

Most of the 21 studies included (71%; n=15) were qualitative. Quantitative studies (n=6) included two cross-sectional surveys, two cohort studies, a case-control study, and another study with a mixed-method approach. The studies came from several countries, primarily the United States (n=13), and included 2,043 patients.

Based on the literature and stakeholder input, Dr. Kokorelias and colleagues identified several major themes that are important to older women with HIV:

• Concerns about sharing HIV status;
• Social support networks and romantic relationships;
• Emotional resilience;
• Spirituality; and
• Health management.

“Key areas for support include sharing HIV status strategies, emotional resilience, social connections, and health management,” Dr. Kokorelias and colleagues noted. “The review advocates for gender-sensitive and culturally appropriate interventions, emphasizing familial and community support. Recommendations include longitudinal studies on the impact of stigma, interventions for intersectional healthcare disparities, and expanded research on diverse groups.”