Clinical characteristics of women with HIV in the RESPOND cohort: A descriptive analysis and comparison to men. HIV Medicine
Women with HIV remain underrepresented in clinical research, yet understanding sex and gender differences is crucial to addressing their unique needs, particularly as the population ages and comorbidities become more prevalent. In a study published in HIV Medicine, Hutchinson et al. provide a comprehensive analysis of the clinical characteristics of women in the RESPOND cohort, a multi-cohort collaboration including over 34,000 people with HIV across Europe and Australia.
The study compared demographics, treatment and health outcomes between women and men with HIV. Women accounted for 26% of the cohort (n=9,019), with a median age of 42 years. The majority (75.8%) acquired HIV through heterosexual contacts, and 30.3% were of African origin. At enrollment in RESPOND, women with HIV had a median CD4 count of 523 cells/μL, and 73.6% achieved HIV viral suppression at some time during the follow-up.
Compared to men who have sex with men, women were more likely to have a nadir CD4 count below 200 cells/μL (9.8% vs. 6.5%). Treatment patterns also differed significantly: women with HIV were more likely to receive protease inhibitors (30.6% vs. 21.1%) and less likely to receive integrase inhibitors (34.6% vs. 45.6%) compared to men who have sex with men. In addition, women with HIV were more likely to be free of comorbidities compared to men (26.9% vs. 20.8%), but had higher rates of chronic kidney disease and non-AIDS-defining malignancies, particularly breast cancer.
These findings highlight key disparities between women with HIV and men with HIV. The lower CD4 nadir among women with HIV may reflect delayed access to care, while the underuse of integrase inhibitors -despite their improved safety and efficacy – suggests a need for interventions to ensure equitable access to optimal treatments.