BC Centre for Excellence in HIV/AIDS research reveals gains in life expectancy for females with HIV lags gains for males with HIV

New study, published in Lancet Public Health, points to immediate need to address structural and socio-economic impacts on health for women with HIV

VANCOUVER, BC, Feb. 6, 2025 /CNW/ - A new research study from the BC Centre for Excellence in HIV/AIDS (BC-CfE) shows that people with HIV (PWH) in British Columbia, Canada are now living much longer than just a few decades ago, but gains in life expectancy for women with HIV are significantly lower than men's.

The study, published in The Lancet Public Health today, shows that both sexes have seen substantial increases in their life expectancy since 2012, when a province-wide expansion of the BC-CfE's Seek and Treat for Optimal Prevention of HIV/AIDS Program (STOP HIV/AIDS) led to intensified HIV testing, treatment and engagement in care.

While the total life expectancy for males with HIV in BC aged 20 rose from 44 years old in the period 1996-2001 to 68 years old in the period 2012-2020, the life expectancy of females with HIV rose from 42 years old in 1996-2001 to 61 years old in 2012-2020. Life expectancy at age 40 and 55 also remained lower among females than males. Meanwhile, the sex gap in life expectancy at ages 20 and 40 increased over time.

BC-CfE researchers also found that females with HIV were at a 33% higher risk of death from non-communicable diseases such as kidney, liver, and lung disease than males with HIV, even after taking into account sex differences in age, socio-economic status, and historic HIV-related immunodeficiency.

"The good news is that both men and women with HIV today are living longer and healthier lives, thanks to the safe and effective HIV treatments that are widely available in British Columbia at no cost to patients," said Dr. Katherine W. Kooij, lead author of the study. "When we initiated this study, we hypothesized that the gap in life expectancy between BC men and women living with HIV would narrow over time, as HIV treatment and care became universally accessible. Instead, the gap grew. 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."

In the BC study population, females more often resided in less affluent neighbourhoods. For instance, approximately 12.3% of females (versus 7.1% of males) lived in Vancouver's Downtown Eastside, a low-income inner-city neighbourhood with high levels of unemployment, housing instability, mental illness, and substance use. Moreover, females more often reported injection drug use as a transmission risk factor and more often met the definition for substance use disorder. These factors explain some of the higher mortality observed among females.

Meanwhile, a large Canada-wide study found that women with HIV more often reported lower income, food insecurity, poor social supports, and discrimination than women without HIV. Females with HIV may also be disproportionally affected by the ongoing drug toxicity and poisoning crisis, which has decreased life expectancy among all PWH in BC but more so among women with HIV.

The new BC-CfE study, titled Life expectancy and mortality among males and females with HIV in British Columbia in 1996–2020: a population-based cohort study, aimed to compare trends in life expectancy between females and males with HIV in BC, Canada since 1996, when BC's universal healthcare system began providing free highly effective antiretroviral therapy [ART] to all British Columbians living with HIV. A better understanding of the sex gap in life expectancy and its determinants are vital to designing targeted programs to improve life expectancy among people living with HIV.

"While we undertake that work, women must be provided with supports such as low-barrier care, better housing and community connection to address the negative disparity we are seeing in their health outcomes," added Dr. Kooij. "These findings also stress the importance of screening and preventative measures for non-communicable diseases among females with HIV. The life expectancy gap between men and women living with HIV should be narrowing, not getting worse."

In addition:

• 11,738 males (82.2%) and 2,534 females (17.8%) with HIV, aged 20 or older, were included in the study.
• Life expectancy is defined as the average number of additional years that a person of a given age is expected to live, if current age-specific mortality rates remain constant over the course of the individual's lifetime.
• Study authors reported sex-stratified life expectancy with 95% confidence intervals at age 20, 40, and 55 for the calendar periods 1996-2001, 2002-2011, and 2012-2020.
• The BC-CfE's study noted that the life expectancy pattern among males and females with HIV differs from the pattern observed in the general population. Globally, females tend to live longer than males.

About the British Columbia Centre for Excellence in HIV/AIDS
The BC Centre for Excellence in HIV/AIDS (BC-CfE) is Canada's largest HIV/AIDS research, treatment and education facility – nationally and internationally recognized as an innovative world leader in combating HIV/AIDS and related diseases. The made-in-BC Treatment as Prevention® strategy (TasP® ) pioneered by BC-CfE, and adopted by UNAIDS since 2011, inspired the ambitious global target for HIV treatment – known as the United Nations' 90-90-90 Target by 2020 and current UN 95-95-95 Target by 2025 – to end AIDS as a pandemic by 2030. The BC-CfE is applying TasP® to therapeutic areas beyond HIV/AIDS, including viral hepatitis and addiction, to promote Targeted Disease Elimination® as a means to contribute to healthcare sustainability. The BC-CfE works in close collaboration with key stakeholders, including government, health authorities, health care providers, academics, and the community to decrease the health burden of HIV/AIDS, hepatitis C and addictions across Canada and around the world.

SOURCE British Columbia Centre for Excellence In HIV/AIDS

For more information, please contact: Ian Noble: [email protected]