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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!) to old age. More than half of people with HIV in the United States are age 50 or older. But HIV is associated with certain medical problems that can affect women with the disease. Here you can find some of the most common ones.
Gynecological medical problems and HIV
Gynecological medical problems affect the female reproductive system. For women and AFAB people living with HIV, these could be:
- Sexually transmitted infections (STIs) such as herpes, pelvic inflammatory disease (PID), and syphilis
- Vulvovaginal candidiasis, also called vaginal candidiasis
- Bacterial vaginosis (BV), another infection that affects the vagina
People with HIV are more susceptible to these problems because HIV weakens the immune system, making it harder for the body to fight infections.
HIV can also affect the menstrual cycle, causing:
- Irregular menstrual periods
- Skipping menstruation
- Spotting (light bleeding between menstrual periods)
- Severe premenstrual syndrome (PMS)
Increased risk of cervical cancer
Cervical cancer begins in the cervix, the lower part of the uterus that connects to the vagina. It is usually caused by infections with certain types of human papillomavirus (HPV).
HPV infection is so common that most people who are not vaccinated against the disease become infected at some point without realizing they have it. However, women with HIV may find it more difficult for their immune systems to clear HPV, increasing their risk of developing cervical cancer.
Read: Summary Information: Here’s everything you need to know about cervical cancer and HPV >>
Increased risk of heart problems
Heart disease is the leading cause of death among women in the United States, and HIV-related heart disease is the 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 of HIV, the effects of some anti-HIV drugs on cholesterol and blood sugar, general risk factors (such as high blood pressure and smoking), and, in some women, hormonal changes associated with menopause.
Side effects and interactions of anti-HIV drugs
While ART works well to keep HIV under control, it also has side effects that can vary depending on the medication. Relatively minor side effects could 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 fatal form of heart arrhythmia), an increased risk of pancreatitis (sudden inflammation of the pancreas), and osteoporosis.
Another concern for women undergoing ART is drug interactions, that is, how these treatments affect other medications they may be taking and vice versa.
ART can affect the way other medications you take work or cause your body to absorb too much medication. And some medications (such as proton pump inhibitors, or PPIs, commonly taken for heartburn) can prevent your body from properly processing ART.
It is important for women with HIV to speak with a healthcare provider or pharmacist before taking any new medication, even if it is a dietary supplement or sold without a prescription, to check for possible drug interactions.
Menopause and other age-related problems
As AFAB people and women with HIV enter menopause, they may find the transition more difficult than other people who do not have the disease. Menopause may come earlier and its symptoms (such as hot flashes and night sweats) may be worse.
Menopause is not the only age-related health change that may occur earlier in women with HIV, on average. 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 the disease.
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 living with HIV are enjoying longer, more fulfilling lives. And while the disease poses unique challenges for AFAB individuals and women, there are resources available to help address these issues.
Organizations like Older Women Embracing Life (OWEL) support women living with HIV and their families and caregivers. You can also talk to your doctor 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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