Women And AIDS -
The Forgotten Epidemic
By Hacsi Horvath
(WebMD) -- When the acronyms "AIDS" and "HIV" first were made known to the world in the early 1980s, it was usually in the context of a strange and deadly new disease that primarily afflicted gay men, recipients of tainted blood transfusions and people who shared needles for injecting illegal drugs. Millions of people have died of acquired immune deficiency syndrome (AIDS) since then, and many of them have not been junkies, blood recipients or gay men: A very large number have been women who acquired the infection through heterosexual sex.
An international crisis
In fact, the number of women with AIDS worldwide has been rising dramatically, particularly in Africa and Southeast Asia, where it is more common for it to be transmitted heterosexually than otherwise. According to CARE, one of the world's largest international relief and development organizations, more than 9 million women are living with AIDS -- 41 percent of all reported cases.
Situation in the United States
In 1996, HIV and AIDS was the fourth-leading cause of death for women in the United States between the ages of 25 and 44. Many of these women were given HIV through sex with infected male partners who were injection-drug users. Nearly 1 million Americans are currently infected with HIV (human immunodeficiency virus, the germ that causes AIDS), of whom around 150,000 are women. Between 1985 and 1997 the proportion of AIDS cases in American women, including adolescents, rose from 7 percent to 22 percent, more than tripling.
More than one way to get it
The problem is compounded because many American women with AIDS may have been infected through a combination of two modes of transmission -- sex and their own intravenous drug use. In addition to the usual risks that come with sharing needles, these drug-abusing women are often having unprotected sex with men who share needles with others. And even if the women are not themselves having sex with multiple partners, the men in their lives may well be -- leading to an elaborate, increasingly risky chain reaction through which HIV and other sexually transmitted diseases are transmitted in all directions.
But HIV and AIDS are not just a threat to women who abuse drugs or who have sex with drug abusers. Any woman (or any man) who has sex with more than one partner is at risk, particularly if that sexual contact is made without correct and consistent use of latex condoms. Young women under the age of 25 are at much greater risk than older women -- not only do they tend to have more sexual partners and to engage in riskier sexual behaviors, they are often unable to negotiate condom use and safer sex practices with their partners.
Much work to be done
Despite the recent promising news about treatments, the AIDS epidemic is not yet over. Although AIDS-related deaths among women in the United States have been decreasing over the past few years because of better HIV and AIDS medications, they have not been decreasing as fast as AIDS-related deaths in men. But the best strategy against HIV and AIDS is still prevention. The Centers for Disease Control and Prevention is actively building better HIV and AIDS prevention programs for women; implementing community-level projects to help young women and ethnic women understand the importance of condom use; and addressing with them the convergence of HIV infection and intravenous drug use. Whether such programs can be developed for the rest of the world remains to be seen.