Women Make Up an Increasing Percentage of
HIV-Infected Patients
By Brian Boyle, MD
A recent study published in the Journal of the American Medical Association
indicates that HIV disease is increasingly becoming a disease of women and that
further research is needed on HIV pathogenesis and therapy in women. The study
reviewed surveillance and prospective cohort studies published between 1981 and
2000 and scientific conference presentations from January, 1999 to July 2000 in
which at least 20 women were enrolled. The purpose of this review was to
provide epidemiologic, clinical, psychosocial and behavioral information about
HIV in women and to provide recommendations for future efforts.
The study found that over the past 15 years, women account for an increased
percentage of HIV-infected persons. In 1986, 6.7% of HIV-infected persons were
women, whereas by 1999 that proportion had risen to 18%. Further, by 1999, 32%
of newly reported HIV diagnoses were in women and women accounted for 23% of
new AIDS diagnoses. Newly reported cases of HIV in women were predominantly in
the South (41%), among black women (61%), and as a result of heterosexual
transmission (38%).
Regarding the natural course of HIV infection and the response to
antiretroviral therapy in women, most studies are limited by the small number
of women enrolled; however, in general, the studies conducted to date indicate
that the natural history and progression of HIV disease, as well as response to
antiretroviral therapy, appear similar in HIV-infected women and men. Despite
this, several studies have shown that women are less likely than men to use
antiretroviral therapy. Although the reasons for this discrepancy remain
unclear, several issues have been identified that interfere with women
preventing or receiving adequate therapy for HIV disease, and these issues
include continued illicit drug use, high-risk sexual behaviors, depression, and
unmet social needs.
Based upon their study, the authors conclude that "as the third decade of
the HIV epidemic begins, continued research on HIV basic science and clinical
research leading to advances in care is needed; however, emphasis should also
be placed on applying existing knowledge about HIV prevention and treatment in
women by enhancing use of available health services and including greater use
of antiretroviral therapy options, treating depression and drug use,
facilitating educational efforts, and providing social support to reduce competing
needs that prevent women from taking control of HIV prevention and
treatment."
3/30/01
Reference
S Hader and others. HIV Infection in Women in the United States. JAMA.
2001; 285:1186-92.
