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HIV/AIDS and Women

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Neelum T Aggarwal MD

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HIV and AIDS were originally thought to affect mostly gay men. However, women have always been affected too. And even though more men than women have HIV, women are catching up. In fact, if new HIV infections continue at their current rate worldwide, women with HIV may soon outnumber men with HIV.

The good news is that many women with HIV are living longer and stronger lives. With proper care and treatment, many women can continue to take care of themselves and others.

In some respects HIV and AIDS affect women in almost the same way they affect men. For example,

Women of color (especially African American women) are the hardest hit.
Younger women are more likely than older women to get HIV.
AIDS is a common killer, second only to cancer and heart disease for women.

1 How are women getting HIV?
2 Prevention Challenges
3 What Women Can Do
4 What CDC is Doing
5 Resources
6 Links

How are women getting HIV?

The most common ways are (in order)

having sex with a man who has HIV
sharing injection drug works (needles, syringes, etc.) used by someone with HIV

Prevention Challenges

Women have unique issues and special challenges that make it harder for them to prevent HIV or take care of themselves if they have HIV.

Women can give HIV to their babies. Women who have HIV can give it to their babies during

pregnancy
delivery
breast-feeding

Women's bodies are different.
A woman is twice as likely as a man to get HIV infection during vaginal sex (because the lining of the vagina provides a large area of potential exposure to HIV-infected semen).

Some diseases or disorders unique to women make HIV more serious.

Women may lack control in relationships.

Scared to say no to sex
Scared to insist their partner (husband or boyfriend) use a condom
Can’t talk to their partner about

abstinence (not having sex)
faithfulness (having only one sex partner)
using condoms

Don’t know if their partner is doing things that put him (and therefore her) at risk for HIV

Women may not earn much money, which makes it hard for them to pay doctors or even get a ride to their doctor appointments. In extreme instances, some women even end up trading sex for money or drugs.
Women may have to find someone to take care of their children while they go to the doctor.
Women may be caregivers for others and not feel they have the time to take care of themselves.
Some women are even afraid to tell their doctors they have HIV, fearing they won’t get good treatment.

What Women Can Do

Your risk of getting HIV or passing it to someone else depends on several things. Do you know what they are? You might want to talk to someone who knows about HIV. You can also do the following:

Abstain from sex (do not have oral, anal, or vaginal sex) until you are in a relationship with only one person, are having sex with only each other, and each of you knows the other’s HIV status.

If both you and your partner have HIV, use condoms to prevent other STDs and possible infection with a different strain of HIV.
If only one of you has HIV, use a latex condom and lubricant every time you have sex.

If you have, or plan to have, more than one sex partner, consider the following:

Get tested for HIV

If you are a woman who is planning to get pregnant or who is pregnant, get tested as soon as possible, before you have your baby.

Talk about HIV and other STDs with each partner before you have sex.
Learn as much as you can about each partner’s past behavior (sex and drug use) and consider the risks to your health before you have sex.
Ask your partners if they have recently been tested for HIV; encourage those who have not been tested to do so.
Use a latex condom and lubricant every time you have sex.
If you think you may have been exposed to another STD such as gonorrhea, syphilis, or Chlamydia trachomatis infection, get treatment. These diseases can increase your risk of getting HIV.

Even if you think you have low risk for HIV infection, get tested whenever you have a regular medical check-up.
Do not inject illicit drugs (drugs not prescribed by your doctor). You can get HIV through needles, syringes, and other works if they are contaminated with the blood of someone who has HIV. Drugs also cloud your mind, which may result in riskier sex.
If you do inject drugs, do the following:

Use only clean needles, syringes, and other works.
Never share needles, syringes, or other works.
Be careful not to expose yourself to another person's blood.
Get tested for HIV test at least once a year.
Consider getting counseling and treatment for your drug use.

Do not have sex when you are taking drugs or drinking alcohol because being high can make you more likely to take risks.

To protect yourself, remember these ABCs:

A=Abstinence

B=Be Faithful

C=Condoms

If you are a woman, there are even more things you can do.

Use a female condom.

Get tested, especially if you’re pregnant.

If you are pregnant and have HIV, talk to your doctor about taking medicine so your baby does not get your HIV.

DO NOT

Do not use spermicides that contain nonoxynol-9 (N-9). This product may help keep you from getting pregnant, but it will not protect you from HIV. In fact, using N-9 often may actually make it easier for you to get HIV.
Do not count on most birth control methods to protect you from HIV. The following birth control methods will NOT protect you from HIV:

The pill
Diaphrams
Shots
Implants
N-9

Do not douche. Douching removes some of your body’s natural protection.

What CDC is Doing

Please note: The reference numbers in the text below will take you to the reference section of the CDC fact sheet HIV/AIDS and Women. CDC is working on a new plan of action that will impact women:

Make HIV testing a routine part of medical care.
Find ways to diagnose HIV outside of doctors’ offices.
Prevent new infections by working with HIV-infected people and their partners.
Decrease mother-to-child HIV transmission.

Programs. CDC has learned that women especially benefit from programs aimed at increasing their awareness of their own risk, their ability to stand up for themselves in sexual situations, and their ability to cope.

Research. CDC provides money and conducts research on ways to help women reduce risk behavior products, like microbicides (gels, creams, or suppositories that kill viruses), to help prevent the spread of HIV helping prevent mother-to-child spread of HIV

Resources

CDC Topic: Pregnancy and Childbirth

One Test. Two Lives: Prenatal HIV Screening Benefits Mom and Baby

Questions and Answers:

Questions and Answers on Subpopulation Estimates from the HIV Incidence Surveillance System – United States, 2006, published in the September 12, 2008 issue of the MMWR

Events:

National Women and Girls HIV/AIDS Awareness Day

Fact Sheets:

Slide Sets:

HIV/AIDS Surveillance in Women

Podcasts:

MMWR Article Provides Additional Detail About HIV Incidence in the United States

Download this podcast, locate accessible versions, and subscribe to podcast series.

This podcast explores a more in-depth look at HIV incidence in specific U.S. populations, with detailed breakdowns of new HIV infections by race, gender, route of transmission, and age.

National Women and Girls HIV/AIDS Awareness Day