B.C. women being treated for HIV have shorter life expectancy than men, study shows

HIV self-test kits, photographed at the Toronto People With Aids Foundation office, in Toronto, Friday, Feb., 16, 2024. (Christopher Katsarov/The Canadian Press)

An antiretroviral treatment has increased the life expectancy of people who live with HIV in British Columbia, but a new study shows men are living longer than women.

Just 18 per cent of the people living with HIV and receiving treatment in the province are women.

The BC Centre for Excellence in HIV/AIDS research paper, published in the peer-reviewed Lancet Public Health, points to an immediate need to address factors such as unemployment and unstable housing that adversely affect the health of women with HIV.

It says women with HIV should be considered a priority for public health strategies in an effort to address structural factors that carry adverse health impacts.

“This is not about the treatment. It’s another strategy. This is our society. We need to recognize that we cannot have a better society if we don’t address the social determinants of health,” said Dr. Julio Montaner, executive director at the centre.

This includes homelessness, poverty, mental health and addictions, he said in an interview on Friday.

“If we don’t address the social, economic, cultural issues that challenge their ability to have a more successful life, then there will always be people who are compromised,” Montaner said, adding that men who share these social determinants are also lagging.

“Among men, the numbers are much larger and there is a large group of men that are actually more social, economically capable, more affluent, more educated.”

The research shows the provincewide expansion of antiretroviral treatment combined with the STOP HIV/AIDS program has increased the life expectancy for men and women, but women are not expected to live as long as men.

It found the life expectancy for 20-year-old men living with HIV between 2012 and 2020 rose to 68 years old, while for women it only increased to 61 years old.

Previously, life expectancy among those with HIV from 1996 to 2001 was only 44 for men and 42 for women.

“The HIV epidemic is largely driven by men having sex with men, and to a lesser extent, by injection drug use and heterosexual sex,” said Katherine Kooij, an epidemiologist and the paper’s lead author, explaining why the vast majority of people living with HIV in B.C. are men.

Researchers found that women with HIV had a 33 per cent higher risk of death from noncommunicable diseases, such as kidney, liver, and lung disease compared with men with HIV.

Kooij said it’s “worrying” that the improvement in life expectancy isn’t as strong among women.

The difference is suspected to be due to environmental or social structural factors, such as barriers to accessing health care, unemployment, poverty, unstable housing, stigma and discrimination, she said.

This report by The Canadian Press was first published Feb. 7, 2025.

Marcy Nicholson, The Canadian Press