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December 1, 2025 is World AIDS Day.
Thanks to a treatment called antiretroviral therapy (ART), people assigned female at birth (AFAB) and women with HIV are now living (and thriving!) into old age. More than half of all people with HIV in the United States are age 50 and older. But HIV is associated with certain health problems that can affect women with the disease. Here are some of the most common ones.
Gynecological health problems and HIV
Gynecological health problems affect the female reproductive system. For women and people with AFAB living with HIV, these may include:
People with HIV are more susceptible to these problems because HIV weakens the immune system, making it harder for the body to fight off infections.
HIV can also affect the menstrual cycle, causing:
- Irregular periods
- Missed period
- Spotting (light bleeding between periods)
- Bad Premenstrual Syndrome (PMS)
Higher risk of cervical cancer
Cervical cancer is cancer that begins in the cervix, the lower part of the uterus that is connected to the vagina. It is usually caused by infection with certain types of human papillomavirus (HPV).
HPV infection is so common that most people who are not vaccinated against it will become infected at some point without ever knowing they have it. However, women with HIV may have a harder time getting rid of HPV’s immune system, putting them at higher risk of developing cervical cancer.
Read: Fast Facts: Here’s what you need to know about cervical cancer and HPV >>
Higher risk of heart problems
Heart disease is the leading cause of death among women in the United States, and HIV-related heart disease is a leading cause of death among women with HIV. The risk of having a heart attack is particularly high among women with HIV, who are three times more likely to have a heart attack than women without HIV.
Scientists believe several factors may contribute, including chronic inflammation and immune activation caused by HIV, the effects of some HIV medications on cholesterol and blood sugar, general risk factors (such as high blood pressure and smoking), and, in some women, hormonal changes during menopause.
Side effects and interactions of HIV medications
While ART works well to keep HIV under control, it also comes with side effects that can vary depending on the medication. Relatively minor side effects may include:
- Upset stomach
- Headache
- Dry mouth
- Sleep problems
- Mood swings
- fatigue
- dizziness
- fatigue
Drugs used to treat HIV are also associated with more serious side effects, including depression, high cholesterol, long QT syndrome (a life-threatening form of heart arrhythmia), an increased risk of pancreatitis (sudden inflammation of the pancreas), and osteoporosis.
Another concern for women on ART is drug interactions, which are the ways in which these treatments affect other medications they may be taking and vice versa.
ART can cause other medications you are taking not to work, or cause your body to absorb too much of the medication. And some medications (like proton pump inhibitors, or PPIs, commonly taken for heartburn) can prevent your body from absorbing enough ART.
It’s important for women with HIV to talk to a health care provider or pharmacist before taking a new medication – even if it’s a dietary supplement or sold over the counter – so they can be aware of possible drug interactions.
Menopause and other age-related problems
As AFAB patients and women with HIV enter menopause, they may find the transition more difficult than those without the disease. You may experience menopause earlier and your symptoms (such as hot flashes and night sweats) may be worse.
Menopause is not the only age-related health change that can occur earlier than average in women with HIV. A study found that common age-related diseases such as kidney disease and diabetes appeared 16 years earlier in people with HIV than in people without HIV.
Experts don’t know exactly why these diseases affect people with HIV more, but they believe inflammation caused by the virus could be an important factor.
Live your best life with HIV
Thanks to modern medicine, people with HIV live longer and more fulfilled lives. And while the disease presents some unique challenges for AFAB patients and women, there are resources available to help you overcome these issues.
Organizations like Older Women Embracing Life (OWEL) provide support for women living with HIV and their families and caregivers. You can also talk to your HCP about what you can do to stay as healthy as possible in your golden years.
This educational resource was created with support from Merck.
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