Perception of medical care among women living with HIV aged 40 years or older–A European-wide survey

OBJECTIVES: Our objective was to explore how women living with HIV aged ≥40 years perceive their care in relation to their HIV infection, comorbidities, and menopausal health and to evaluate the extent to which the care they receive meets their expectations, comparatively across World Health Organization (WHO) European regions. METHODS: We conducted a cross-sectional survey (May-December 2023) among women living with HIV aged ≥40 years from the WHO European region. Five dimensions of care were assessed: content of care, information, relationship with caregiver, organization of care, and patients' rights and privacy, in addition to management of non-HIV comorbidities and menopause. RESULTS: In total, 600 women completed the survey; they were predominantly from the Western European region (70.2%), followed by the Eastern (20.2%) and Central (9.6%) regions. The majority of women (46.5%-95.1%) described positive experiences, responding that they were 'always' or 'usually' satisfied with the five dimensions of HIV care. The concordance between perceptions and experiences of HIV care ranged from 49.4% to 96.1% and was lower in the Eastern region. Among menopausal women, 58.5% were 'very satisfied' or 'satisfied' with the care they received; satisfaction was significantly lower in Eastern European countries than in Western countries. CONCLUSIONS: Our results highlighted a generally high concordance between respondents' expectations and the services provided, including both HIV and non-HIV care. Women aged ≥40 years living with HIV face several challenges that should be addressed. These findings inform stakeholders and decision-makers about the need to adopt a more inclusive and sensitive approach in healthcare systems.