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Women and children
P91 Care of HIV+ women aged 50 and over: can we do better?
  1. I Samuel,
  2. J Welch,
  3. M Tenant-Flowers,
  4. M Poulton,
  5. C Taylor
  1. King's College Hospital NHS Trust, London, UK

Abstract

Background The prevalence of ageing HIV infected females continues to increase due to greater survival, delayed diagnosis and new infections; management of specific issues in this group becomes more challenging.

Aims/Objective To identify the specific care issues for women at and above 50 years.

Method Female patients aged 50 and over were identified from a female cohort of 828 and data collected retrospectively from case notes and electronic patient records.

Results and Discussion The sample consisted of 124 (15% of 828) women, mean age 52 y, range 50–75 y; 83% black ethnicity. 40.3% diagnosed at 50 y or over. CD4 counts, mean 217 cells/μl indicating 71% late diagnoses and 42% with advanced/very advanced HIV. 22.6% of the sample had attended hospital before and missed the opportunities for early diagnosis suggesting wider testing even in elderly. 4.5% women had premature menopause compared to <1% in the general population, 7.1% early menopause, 28% had menopausal symptoms, 10% had HRT. On opportunistic testing of BMD tests, 5/8 women had evidence of osteoporosis/osteopenia. 54% of the whole group had vitamin D deficiency. 38% had abnormal cervical cytology, of which 16.5% were high grade. A high degree of obesity (48%) and other co-morbidities (90%) identified.

Conclusions Special care for premature/early menopause including early counselling regarding reproductive options, wider HIV testing regardless of age, screening for osteoporosis, breast and cervical cancer, holistic approach in the management of obesity and other co-morbidities. Consideration needed as to how care is provided for this group within current health care settings.

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