CROI 2014: With HIV treatment lag for men, life expectancy gender gap widens

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CROI2014BOSTON, MASS. – When antiretroviral treatment finally came to rural South Africa, it led to one of the fastest life expectancy recoveries in public health history. But men did not benefit equally, according to data presented Thursday by Till Barnighausen from the Africa Centre for Health and Population Studies and the Harvard School of Public Health.

Eight years later, life expectancy of men in rural KwaZulu Natal, South Africa continues to lag behind that of women with the gap widened by differences in access to, and uptake of antiretroviral treatment, Barnighausen said. In one of the poorest regions of the world with two-thirds unemployment, Barnighausen and his colleagues studied 90,000 people using life expectancy as the summary statistic for the ultimate population benefit of antiretroviral therapy. While one in six adults is enrolled in HIV care, with an HIV prevalence of 30 percent, early mortality is still very high and HIV infection is still a major contributor.

The researchers found that 57 percent of deaths among men and 41 percent of deaths among women occurred before HIV care was sought. Between 2004 and 2011, men were 25 percent more likely to die of HIV-related illnesses than women. Although life expectancy has increased for all in the region, between 2004 and 2012, the gender gap has widened from four years, with men facing an average life expectancy of 46 years while women faced an average life expectancy of 50, to now more than 9 years with an average life expectancy of 55 years for men, as opposed to a life expectancy of 64 years for women.

Barnighausen offered no quick solutions, but did flag a social marketing campaign supported through PEPFAR that links antiretroviral therapy with the the economic benefit of returning to work.  He also suggested that more male-friendly clinics would help, as would recruitment of more men into nursing.

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