754b182675fbc98a9a1d53211cf517fb viruses-18-00742.pdf e32b0ae6e1a4b7187f25e15cb3cd16dc0b57a5d3 viruses-18-00742.pdf af4417bf6c20236fda48ab34f4de2e718e6e5a675372acb2e04c194395a657fd viruses-18-00742.pdf Title: Gender-Specific Determinants of Frailty in Aging People with HIV: Evidence for a Multidimensional Vulnerability Phenotype in Women Subject: Background: Gender differences in aging among people with HIV (PWH) remain poorly characterized. Women with HIV (WWH) may experience more complex aging trajectories, due to the interplay of biological, clinical, and psychosocial factors. In this context, we aimed to investigate gender-specific determinants of frailty among older people with HIV, with a particular focus on women, to better inform tailored clinical care. Methods: Cross-sectional analysis of the Over50 Cohort, including PWH aged 50 years from two tertiary hospitals in Spain. Participants underwent a comprehensive geriatric assessment across demographic, clinical, functional, cognitive, psychological, and social domains. Gender-stratified multivariable analyses examined frailty (by Fried criteria) and associated factors. Results: Among 588 participants, 139 (23.6%) were cisgender WWH. Despite younger age and better immune status, WWH showed higher prevalence of frailty (17% vs. 9%), musculoskeletal disease (47% vs. 28%), depressive symptoms (45% vs. 30%), sleep disturbances (10% vs. 5%), and cognitive complaints (23% vs. 11%). Men with HIV (MWH) more frequently had cardiovascular (48% vs. 35%) and renal disease (22% vs. 15%). In multivariable models, frailty in WWH was independently associated with musculoskeletal disease (OR 3.85), cognitive impairment (OR 3.21), depressive symptoms (OR 2.67), and malnutrition (OR 2.14). In MWH, frailty was associated with musculoskeletal disease, cognitive impairment, malnutrition, and older age. Conclusions: Frailty exhibits gender-specific patterns: a multidimensional phenotype in WWH versus age-driven in MWH, supporting tailored, gender-responsive care integrating geriatric, mental, and musculoskeletal health. Keywords: gender differences; aging; frailty phenotype; multidimensional vulnerability; women aging with HIV; gender-sensitive HIV Author: Patricia Echeverría, Jordi Puig, Ana Martínez, Itziar Arrieta, Isabel Arnau, Lucía Bailón, Carla Estany, Begoña Lemos, Anna Bonjoch, Robert Güerri and Eugenia Negredo Creator: LaTeX with hyperref Producer: pdfTeX-1.40.25; modified using OpenPDF 1.4.2 CreationDate: Sat Jul 4 10:47:28 2026 CEST ModDate: Sat Jul 4 10:55:30 2026 CEST Custom Metadata: yes Metadata Stream: no Tagged: no UserProperties: no Suspects: no Form: none JavaScript: no Pages: 14 Encrypted: no Page size: 595.276 x 841.89 pts (A4) Page rot: 0 File size: 268412 bytes Optimized: no PDF version: 1.7 name type encoding emb sub uni object ID ------------------------------------ ----------------- ---------------- --- --- --- --------- KCUYJO+URWPalladioL-Roma Type 1 Custom yes yes yes 104 0 QQNVLD+URWPalladioL-Ital Type 1 Custom yes yes yes 105 0 MIKRSI+VnURWPalladioL Type 1 Custom yes yes yes 106 0 ZZLTBA+CMSY10 Type 1 Builtin yes yes yes 107 0 NJYHFQ+URWPalladioL-Bold Type 1 Custom yes yes yes 108 0 WBVKDJ+URWPalladioL-BoldItal Type 1 Custom yes yes yes 175 0 JLZORU+EURM10 Type 1 Builtin yes yes yes 184 0 Jhove (Rel. 1.28.0, 2023-05-18) Date: 2026-09-30 03:57:30 CEST RepresentationInformation: viruses-18-00742.pdf ReportingModule: PDF-hul, Rel. 1.12.4 (2023-03-16) LastModified: 2026-09-29 14:07:38 CEST Size: 268412 Format: PDF Version: 1.7 Status: Well-Formed and valid SignatureMatches: PDF-hul MIMEtype: application/pdf PDFMetadata: Objects: 382 FreeObjects: 1 IncrementalUpdates: 0 DocumentCatalog: ViewerPreferences: HideToolbar: false HideMenubar: false HideWindowUI: false FitWindow: true CenterWindow: false DisplayDocTitle: false NonFullScreenPageMode: UseNone Direction: L2R ViewArea: CropBox ViewClip: CropBox PrintArea: CropBox PageClip: CropBox PageLayout: SinglePage PageMode: UseNone Outlines: Item: Title: Introduction Item: Title: Materials and Methods Children: Item: Title: Study Design and Population Section Item: Title: Study Objectives and Endpoints Item: Title: Statistical Analysis Item: Title: Results Children: Item: Title: Demographic and HIV-Related Characteristics Item: Title: Comorbidities, Geriatric Syndromes and Psychosocial Domains Item: Title: Comparative Analysis Between Frail and Robust Participants in Overall Population Item: Title: Patterns of Frailty According to Gender Item: Title: Associations with Frailty According to Gender Item: Title: Discussion Item: Title: Conclusions Item: Title: References Info: Title: Gender-Specific Determinants of Frailty in Aging People with HIV: Evidence for a Multidimensional Vulnerability Phenotype in Women Author: Patricia Echeverría, Jordi Puig, Ana Martínez, Itziar Arrieta, Isabel Arnau, Lucía Bailón, Carla Estany, Begoña Lemos, Anna Bonjoch, Robert Güerri and Eugenia Negredo Subject: Background: Gender differences in aging among people with HIV (PWH) remain poorly characterized. Women with HIV (WWH) may experience more complex aging trajectories, due to the interplay of biological, clinical, and psychosocial factors. In this context, we aimed to investigate gender-specific determinants of frailty among older people with HIV, with a particular focus on women, to better inform tailored clinical care. Methods: Cross-sectional analysis of the Over50 Cohort, including PWH aged 50 years from two tertiary hospitals in Spain. Participants underwent a comprehensive geriatric assessment across demographic, clinical, functional, cognitive, psychological, and social domains. Gender-stratified multivariable analyses examined frailty (by Fried criteria) and associated factors. Results: Among 588 participants, 139 (23.6%) were cisgender WWH. Despite younger age and better immune status, WWH showed higher prevalence of frailty (17% vs. 9%), musculoskeletal disease (47% vs. 28%), depressive symptoms (45% vs. 30%), sleep disturbances (10% vs. 5%), and cognitive complaints (23% vs. 11%). Men with HIV (MWH) more frequently had cardiovascular (48% vs. 35%) and renal disease (22% vs. 15%). In multivariable models, frailty in WWH was independently associated with musculoskeletal disease (OR 3.85), cognitive impairment (OR 3.21), depressive symptoms (OR 2.67), and malnutrition (OR 2.14). In MWH, frailty was associated with musculoskeletal disease, cognitive impairment, malnutrition, and older age. Conclusions: Frailty exhibits gender-specific patterns: a multidimensional phenotype in WWH versus age-driven in MWH, supporting tailored, gender-responsive care integrating geriatric, mental, and musculoskeletal health. 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