ART helps HIV positive women live beyond 50 years  

Roselyne Sachiti

Tendayi Westerhof, has been living with HIV for 22 years.

For two decades, Westerhof has kept a close eye on developments in HIV research and treatment, issues to do with access to treatment, information dissemination and advocacy.

A National Aids Council (NAC) board member representing persons living with HIV, she, too, has watched other HIV positive people living healthy lives and reaching old age, something that was not possible in the past.

All this, she says, is due to effective Antiretroviral Therapy (ART), which has changed the course of HIV infection from being considered a fatal illness to a chronic manageable condition.

According to a UNAIDS Gap Report (2014), the increasing number of people living with HIV aged 50 and older is largely due to ART which has been successful in prolonging the lives of people living with HIV.

Moreover, the life expectancy of a person living with HIV who achieves and maintains viral suppression on antiretroviral therapy is now similar to that of a person who has not acquired HIV.

However, what is interesting is how the trend of decreasing HIV incidence among younger adults is shifting the proportion of disease burden to older age groups.

In Zimbabwe and across the globe, the number of people who are more than 50 years old and living with HIV has increased due to the success of national ART programmes.

National HIV Estimates, 2022 point out that 272 240 people above 50 years old were living with HIV in Zimbabwe.

Now 56 years old, Westerhof has lived long to witness and testify the successes of HIV response interventions made by the Government and donor partners.

However, she says more needs to be done in terms of inclusion as HIV positive women in her age group have higher rates of comorbidities such as hypertension, diabetes mellitus, depression, chronic kidney disease, liver diseases, arthritis, and cancers.

Speaking to The Sunday Mail, Westerhof who is also the Pan African Positive Women’s Coalition (PAPWC) Zimbabwe National Director said ageing women and men living with HIV are a specific sub-group that has been significantly left behind and in urgent need of targeted inclusion.

She revealed how PAPWC-Zimbabwe continues to advocate and lobby towards an increase in investment for those above the age of 50 years.

“PAPWC-ZIM in collaboration with the Zimbabwe National Network of People Living with HIV/AIDS (ZNNP+) and with support from the Global Fund Community Rights and Gender Strategic Initiatives (CRG SI) conducted evidence generation consultations across the country.

 “The aim was to meaningfully involve ageing Women Living with HIV (WLHIV) during the New Funding Model (NFM4) / Grant Cycle 7 Funding Request country processes.

“PAPWC-ZIM brought together women aged 50 years and above from various geographical locations across the country namely from urban, peri-urbans, rural, border towns, mining and the farming community in February 2023.”

This she revealed, was necessitated after realising that most women and men above the age of 50 years, were not actively participating in country processes towards funding requests, thereby diminishing their chances to receive targeted allocations and programme designs specifically for them as a sub-group.

She emphasised that increasing funding allocation for ageing women living with HIV matters.

 “Ageing WLWHIV face new challenges such as higher rates of comorbidities such as hypertension, diabetes mellitus, depression, chronic kidney disease, liver diseases, arthritis, and cancers.

“Ageing women face barriers in active and equal participation in local and national fora for decision making and policy formulation, which is a clear indication of their institutional exclusion from processes that affect their livelihoods and well-being.”

According to Westerhof, ageing women also face significant social, psychological and physical challenges including depression, stress, anxiety and fear, stigma and discrimination by others, inability to work due to poor health condition, loss of employment leading to a reduction in or loss of family incomes, increased health expenditure and mental health problems.

She called for the national ART programme to offer comprehensive care of ageing women living with HIV, screening and management of comorbidities that must be available at an affordable cost to vulnerable members of society.

“We call for basic essential tools such as blood pressure machines, blood sugar testing, mental health screening tools and kidney function tests to be made accessible to ageing women living with HIV, as part of integrated care of PLWHIV,” she pointed out.

She suggested the training of healthcare workers working in HIV treatment programmes, to strengthen their capacity on how to prevent, diagnose and manage common comorbidities.

“As elderly patients are likely to be receiving other medicines for comorbidities, clinicians must be aware for possible drug-drug interactions and how to manage them.

“There is need to improve access to ART medicines that have better side effect profile such as Tenofovir Alafenamide (TAF).

“We call for routine laboratory monitoring for renal and liver impairment to be strengthened in this sub-group,” she added.

Westerhof also emphasised the need for provision of mental health services that target ageing men and women living with HIV.

“We call for provision of long-term care coverage for ageing women in programmes that focus on prevention against all forms of stigma, discrimination and gender based violence.

“We call for ageing women living with HIV to be viewed as integral part of policy decision making and programming in the HIV response.”

  As the country marks Women’s Month, it is important to ensure women of all age groups are not left out of important health interventions.

@RoselyneSachiti