A snapshot of the lives of positive women in Australia today.
Some things are changing for women with HIV over the last few years: More women are taking up HIV treatments, and fewer are reporting incidences of unwanted disclosure (which is an encouraging trend at least). However, much less encouragingly, there has been little change in the number of women living below the poverty line. Those are some of the insights from Futures.
HIV Futures is a survey of the health and wellbeing of positive people in Australia, and is published by the Australian Research Centre in Sex, Health and Society (ARCSHS) at La Trobe University in Melbourne. The first Futures survey came out in 1997, and now that another four have been published since then (in 1999, 2001, 2003 and 2005), we can see some of the trends emerging in the lives of HIV positive people across the country. Along with each of the five reports, ARCSHS also publishes women’s reports, and these ensure a continued focus on the particular experiences and needs of positive women. The latest one: the Futures 5 women’s report (Life as women know it: Women living with HIV in Australia) has recently been published and is available online.
The latest HIV Futures survey was completed by 982 positive people in 2005. 84 women participated in this current survey, which represents approximately 5.8% of the positive women in Australia. Their ages ranged from 25 to 78 years. Here are a few of its major findings.
HIV and other major health conditions
Thirty one women (39%) indicated that they had been diagnosed with a major health condition other than HIV/AIDS. The most common major health condition affecting women was Hepatitis C. 24.2% of women (18) said that they had ever had hepatitis C.
Mental health of women
Just over one third of women (28) have been diagnosed with a mental health condition, eight of them in the previous two years. Depression was the most common condition diagnosed, and this was reported by 33.2% of women. In comparison, the National Health Survey found that six percent of women in the general population reported both anxiety related problems and mood problems.
Another important health monitoring issue for positive women
All women reported having a cervical smear or Pap test (98.7%), and 80% said they had a test in the last twelve months. The CDC (Centre for Disease Control) recommends that all HIV positive women have a pap smear every year. This means that up to 20% of women who should have had an annual pap smear had not, although it may be possible that some of these women did not require one.
HIV Treatments and complimentary therapies
Women were significantly less likely to be using antiretroviral treatments (ARV) than men in the 1997 and 1999 surveys. By 2001, this difference was no longer significant and in 2003 the proportions of men and women using ARV was the same. By 2005 the proportion of women using ARV was slightly higher than men, and for both men and women was higher than in 2003. Women were also more likely than men to have complimentary therapies in the last six months (81.6% vs 76.1%)
What information do women lack?
30% of women surveyed said that lack of information made it difficult for them to make decisions about living with HIV. The most common areas in which this applied were: managing side effects of treatments, legal issues, and work. Six of the women surveyed said they lacked information about having children.
Unwanted disclosure: some progress to report
Respondents were asked if their HIV status had ever been disclosed without their permission. 60.3% of women said that it had at some point, and 22.3% in the last two years. However, this is down from 37.5% of women from the previous Futures survey reporting unwanted disclosure in the last two years. In that survey 27.2% of women reporting unwanted disclosure had nominated a worker in a health care setting as the source. In the current survey, only 11.4% reported this as the source of unwanted disclosure. The previous survey reported that women were significantly more likely than men to have experienced unwanted disclosure, however in the current survey there was no gender difference on this issue.
Disclosing to children: changing patterns
Of the 50 women who had children, 15 (or 30.5%) said that they had told their child or children about their HIV status. This is down from 64.9% of women in the previous survey who had disclosed to their children. The age of the children at the time of disclosure ranged from two years to 53 years. Of the women with dependent children, 11 (or 35.5%) said they had disclosed to their children.
Women with children were more likely to be using antiretrovirals (86.3% vs 67.9%)
Regular partners
Just over half or 55.9% of women said they were in a regular relationship. Of those in a relationship with a regular partner, 24.6% of women reported that their partner was also HIV positive.
Compared to men, women were significantly more likely to disagree (51% vs 31.2%) or express uncertainty (25.5% vs 16.7%) about the statement “I prefer to have a relationship with someone who also has HIV.” Women were also significantly more likely than men to agree (63.5% vs 53.5%) or to be unsure (14.6% vs 7.9%) that they were afraid of telling potential partners of their HIV status in case they were rejected. The majority of both women and men agreed that they were afraid of infecting their partner, or potential partner, with HIV; however women were significantly more likely to do so than men (75.3% vs 67.7%)
Smoking: a comparison
38.5% of women reported smoking cigarettes in the last twelve months. This compares with the finding form the most recent National Health Survey that 20% of women in the general population were current smokers (ABS, 2006).
The world of work
Just over half (55.8%) of the women were in paid employment, with similar numbers engaged in part time and full time work. The remaining women were either not working or retired (15.3%) or occupied with home duties (13.3%), with similar numbers being unemployed or students. Women were more likely than men to be working part time (26% compared with 17%) and to be occupied with home duties (16% compared with 1.7%) and less likely to be working full time (28% compared with 34.5%) or not working or retired (17% compared with 26%).
Sources of income
A government benefit was the most common income source, and was nominated by 46.8% of women (decreasing slightly from the 1997 figure of 54%). Only a slightly smaller proportion (42.5%) nominated salary in response to this question (and that has increased from around 20% in 1997). Compared with men, women were significantly less likely to nominate their main source of income as salary or superannuation/annuity/savings and more likely to report that their partner supported them.
Poverty is still an issue
Around one third (34.5%) of women in the survey were still living below the poverty line, and is slightly higher than the current figure for men (28.1%). The proportion of women living in poverty peaked at 46% in 1999, but has slightly increased since the last survey. The Futures report calls for “decisive action to address this pocket of severe social disadvantage.”
These of course are just some of the report’s findings, and the full report can be found on the ARCSHS website: www.latrobe.edu.au/arcshs. The authors of Life as women know it are Rachel Thorpe, Karalyn McDonald and Jeffrey Grierson.
