Fact Sheet 610

Women and HIV

HOW SERIOUS IS HIV FOR WOMEN?
WHAT DO WOMEN NEED TO KNOW?
WHAT DO RESEARCHERS NEED TO KNOW?
TREATMENT FOR WOMEN
THE BOTTOM LINE
 

HOW SERIOUS IS HIV FOR WOMEN?

Only 7% of AIDS cases reported in 1985 in the US were women and girls. That percentage grew to 27% in 2007. About 80% of women are infected through sex with an HIV-infected man (often an injection drug user), and many through drug use (see Fact Sheet 154 on Drug Use and HIV). In the US, AIDS rates among women are highest in the Southeast and the Northeast. In 2005, about 64% of infected women in the US were Black, although only 12% of the US population is Black. See fact sheet 611 for more information on pregnancy and HIV. 

 WHAT DO WOMEN NEED TO KNOW?

• Women are at risk for HIV infection. Many women think AIDS is a disease of gay men. But women get HIV from sharing needles and from heterosexual sex. Many women with HIV do not know how they got infected, so they probably don't know if their male partners are infected or not.
• During sex, HIV is transmitted from men to women about twice as more easily as from women to men. A woman’s risk of infection is highest with anal intercourse, or if she has a vaginal disease. The risk of infection is higher if your sex partner is or was an injection drug user, has other sex partners, has had sex with infected people, or has sex with men.
• Women should protect themselves against HIV infection. Having male sex partners use condoms lowers the chance of HIV infection. See Fact Sheet 153 for more information on using condoms. There is a female condom that provides some protection, but not as much as a male condom. Other forms of birth control, such as birth control pills, diaphragms, or implants do NOT provide protection against HIV. There is not yet any cream or gel (microbicide) that women can use to prevent HIV infection. See fact sheet 157.
• Women should get tested for HIV. Many women don’t find out they have HIV until they become ill or get tested during pregnancy. Women who aren’t tested for HIV seem to get sick and die faster than men. But if they get tested and treated, they live as long as men. Fact sheet 102 has more information on HIV testing.
• Gynecological problems can be early signs of HIV infection. Ulcers in the vagina, persistent yeast infections, and severe pelvic inflammatory disease (PID) can be signs of HIV. Hormone changes, birth control pills, or antibiotics can also cause these vaginal problems. See your health care provider to make sure you know the cause.
• Women get more and different side effects than men. On average, women weigh less than men and might have higher blood levels of drugs. Women are more likely than men to get skin rashes and liver problems, and to experience body shape changes (lipodystrophy, see fact sheet 553) . Bone loss is also a concern (see fact sheet 557.) They also have more problems caused by human papillomavirus (HPV, see fact sheet 510.) HPV does not seem to improve when people take antiretroviral therapy (ART).
• Many women are parents in addition to dealing with their health and employment. This can make it more difficult to take medications and schedule medical appointments. With proper support, however, women do very well on HIV treatment.

RESEARCH ON WOMEN

In 1997 the FDA said that women could no longer be kept out of clinical trials just because they might become pregnant. The proportion of women in AIDS research studies is increasing but is still quite low.

More studies of women with HIV are underway. Pharmaceutical companies are trying to enroll more women into their clinical trials. This is necessary because women have been under-represented in most medical research, not just on AIDS. Most medications have never been specifically tested in women.

A recent study found a higher risk of death among HIV+ women due to accident or injury with a lower T-cell count, who were unemployed, who had more than 8 alcoholic drinks each week, who showed signs ot depression, who used injection drugs, or who had 3-5 sex partners.

 TREATMENT FOR WOMEN

In the US, fewer women than men are getting HIV treatment. This may be partly due to suspicion about the health care system and discrimination against people with HIV. Women with HIV should be treated by health care providers with experience treating women with HIV.

Women with HIV get vaginal infections, genital ulcers, pelvic inflammatory disease, and genital warts more often and more severely than uninfected women.

• Only 1 woman gets Kaposi’s sarcoma, a skin cancer (See Fact Sheet 511), for every 8 men who get it.
• Women get thrush (a fungal infection, Fact Sheet 501) in their throats and herpes (see fact sheet 508) about 30% more often than men.
• Women are much more likely than men to get a severe rash when using nevirapine (See Fact Sheet 431.)
• Women with fat redistribution (see Fact Sheet 553 on Lipodystrophy) are more likely than men to accumulate fat in the abdomen or breast areas and are less likely to lose fat in the arms or legs.
• Unusual growths related to cervical cancer are more frequent and severe in women who are HIV-positive. See fact sheet 510 for more information.

THE BOTTOM LINE

More women are becoming infected with HIV. With early testing and treatment, women with HIV can live as long as men. Women should get tested for HIV. This is especially true for pregnant women. If they test positive for HIV, they can take steps to reduce the risk of infecting their babies.

The best way to prevent infection in heterosexual sex is with the male condom. Other birth control methods do not protect against HIV. Women who use intravenous drugs should not share equipment.

Women should discuss vaginal problems with their health care provider, especially yeast infections that don’t go away or vaginal ulcers (sores). These could be signs of HIV infection.