HIV survivors in a resource-rich setting: middle-aged and older HIV-infected sub-Saharan African migrant women in Belgium

Agnes E. Arrey1, Johan Bilsen1, Patrick Lacor2 and
Reginald Deschepper1

1Mental Health and Wellbeing Research Group, Department of Public Health, Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel, Brussels, Belgium; 2Department of Internal Medicine and Infectious
Diseases, AIDS Reference Center, Universitair Ziekenhuis Brussel, Brussels, Belgium

Abstract
The population of HIV-infected women is increasing as antiretroviral therapy coverage continues to expand worldwide. Limited research has explored the challenges middle-aged and older migrant women from sub-Saharan Africa (SSA) face as they survive and grow older with HIV in a resource-rich setting such as Belgium. These women are likely to be invisible to care interventions that may help them age well with this disease. The aim of this paper is to explore the challenges SSA migrant women face on surviving and ageing with HIV, and understand what helps them to persist in HIV care and management. We conducted a qualitative study consisting of semistructured interviews with middle-aged and older SSA women in Belgium, recruited through purposive and snowball sampling. Thematic analysis was used to analyse data. The study was approved by the Ethics Committees of the Universitair Ziekenhuis Brussels and the Internal Review Board of the Institute of Tropical Medicine, Antwerp, Belgium. We interviewed 21 SSA women, aged 45 years and older. Themes that emerged from the data include health, financial and psychosocial challenges. Most participants acknowledged hardships including loneliness and stigma as they aged and an inability to work. Middle-aged and older women living with HIV in Belgium struggled with critical physical and mental health, financial and psychosocial issues required to age well with this disease. However, participants mentioned great reliance on spiritual and social support to help them sustain their ageing, physical and mental health hurdles. Culture-tailored interventions focused on this group of women are essential future hospice care needs, considering the high stigma and discrimination associated with HIV-infected patients.
Keywords: ageing, HIV, survivors, sub-Saharan African migrant women, Belgiumtor Simple Text