A study looking at women aged over 45 living with HIV in the UK has found that while black African and Caribbean women experience greater social isolation and subjective mental distress than white women, they are less likely ever to have been diagnosed with depression or have it treated.
Older African women were also more likely to experience poverty than white or Caribbean women despite being twice as likely to have had a university education.
Psychological distress had a potential impact on health, as women with moderate or severe distress were 75% more likely to have missed clinic appointments in the last year and more than twice as likely to have missed doses of their antiretroviral therapy in the last week.
These findings from the PRIME study were presented to the British HIV Association (BHIVA) conference two weeks ago by Dr Rageshri Dhairyawan of the Barts and Royal London NHS Trust. She said that the ageing of the HIV-positive population in the UK was particularly accentuated in women. In 2006, 14% of women with HIV in the UK were over 45 years old and 44% under 35; in 2016, 52% were over 45 and 15% under 35.
Women with health issues were affected by both their gender and their age, Dr Dhairyawan said. General health surveys show that being female is associated with a poorer health-related quality of life in older people; older women have a lower socioeconomic status than men; and black and minority ethnic (BAME) women have worse mental health as they age than white women.
Surveys of HIV-positive women in the past had found that women were more likely to be diagnosed with depression than their male counterparts and that depression was related to poorer HIV health outcomes. They also found that 45% of HIV-positive women in the UK were living below the poverty line and that poverty was also related to poorer HIV health outcomes.
So one of the objectives of the PRIME study was to explore the relationship between ethnicity and socioeconomic status, ethnicity and mental health, and mental health and HIV-related health in women over 45.