“I'm not gonna die from this HIV”: African American women aging with HIV and comorbidities

Background: Advancements in HIV treatment have resulted in increased life expectancy for many women. Due to the natural progression of aging, as well as accelerated aging caused by HIV, many African American women aged 50 and over will experience at least one other comorbid condition including diabetes, heart disease, and cancer. This qualitative study describes women's perceptions regarding how the aging process is influencing their HIV and other comorbid illness self-management.

Methods: Five focus groups were conducted in Washington, D.C., with HIV positive African American women aged 52 – 65 with at least one comorbid condition. Topics discussed included HIV self-management, comorbid illness self-management, social support, facilitators and barriers to medication adherence, and plans for growing older. A constant comparison approach was applied during data analysis.

Results: Results suggest that neither aging nor HIV are at the forefront of women's concerns when they discuss their illness self-management. Participants reported feeling more likely to die from a comorbid condition relative to HIV. Conditions, including diabetes, cancer, and hypertension, were perceived to be more difficult to self-manage than HIV. This difficulty was attributed not to aging but to daily life struggles such as lack of transportation, income, and romantic male companionship.

Conclusion: HIV and chronic illness specialists need to be aware of how daily life experiences of older African American women influence their ability to effectively manage HIV and comorbid conditions. Findings provide recommendations for providers to enhance their treatment plans and conversations with their older HIV positive African American women patients.