Aging Mexican Women Living with HIV: Responding to Structural Oppression through Agency and Care Practices

Introduction. Aging Mexican women living with HIV (AMWLWH) experience intersecting inequities associated with gender, age, socioeconomic status, and in some cases, Indigenous origin, shaping their access to HIV care. Objective: Analyze how AMWLWH respond to these conditions of structural oppression through agency and care practices. Method. Qualitative study conducted at a public HIV clinic in Mexico City (July 2024-March 2025). Twenty-seven cisgender AMWLWH aged ≥ 50 participated in semi-structured, face-to-face, Spanish-language interviews. Data were analyzed using reflexive thematic analysis and interpreted through an intersectional lens. Results. AMWLWH responded to structural oppression by continuing to engage in precarious work, protecting the continuity of HIV care, practicing self- and collective care, sharing situated knowledge, re-signifying aging, and imagining preferred futures centered on autonomy and dignity. Discussion and conclusion. AMWLWH actively negotiate structural constraints through self- and collective-care practices, economic strategies, and re-authoring later-life identities. Interventions and policies designed to enhance women’s agency, address age- and gender-related barriers, and support community-based care are essential to improving later-life wellbeing among AMWLWH.