Life expectancy of women with HIV in B.C. hasn't increased as much as men's: new research
British Columbians with HIV are living much longer now than a few decades ago, but less so for women than men
While British Columbians living with HIV are living much longer than a few decades ago, the life expectancy for women isn't increasing at the same rate as men's, according to a recent study by the B.C. Centre for Excellence in HIV/AIDS.
Data gathered between 1996 to 2001 and 2012 to 2020 shows that in B.C., men's life expectancy rose from 44 to 68 years old, while the life expectancy for women only rose from 42 to 61 years old.
B.C.'s healthcare system began providing free, highly effective antiretroviral therapy to people living with HIV 1996 which, as the authors note, increased life expectancy substantially.
Researchers had expected the life expectancy gap between men and women to narrow over time, but were surprised to find the gap widened.
"The life expectancy gap between men and women living with HIV should be narrowing, not getting worse," said the study's lead author Katherine W. Kooij in a release.
They noted that this differs from what is observed in the general population globally, where women with HIV tend to live longer than men.
"We suspect that this discrepancy is driven by an unequal burden on women due to adverse socio-structural factors including barriers to accessing healthcare, unemployment, poverty, unstable housing, stigma, and discrimination," it said.
In the population studied, women more often lived in less wealthy neighborhoods and more often reported injection drugs as a transmission risk factor. In addition, women with HIV more often had substance use disorders than men with HIV.
Scott Elliott, CEO of the Dr. Peter Centre, which serves people living with HIV in Vancouver, said the organization has been working to strengthen its programs for women.
He said that, based on his experience, it is harder to attract and keep women in care programs than it is men, because women are often caregivers themselves.
"They're taking care of others. Many of them have kids and families," he said. "And so they often don't come into care… until it's very, very advanced."
Elliott said that because men make up the majority of the population of people living with HIV, many of the support programs in Vancouver and across the country are designed for men, or are overrun by men.
"We get a lot of resistance or a lot of shame and a lot of fear about women coming into services," said Elliott, adding the Dr. Peter Centre has introduced women's only programming to try to mitigate this.
He said the key to helping women with HIV is ensuring they have access to care that works for them. What has worked for the Dr. Peter Centre is to have a long-term relationship with the patient.
"It's a complex illness," he said.
"If they're going to a doctor's office and have to wait two hours, it's not gonna work... If there's other aspects like food, housing, access to medication that isn't looked after, it's not gonna work."
The study recommends women with HIV be provided with better supports, including low-barrier care, better housing and community connection.
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