More than 35 years have passed since the first diagnosis of AIDS (Acquired Immune Deficiency Syndrome) in the US. While there were a handful of women among the first cases, AIDS primarily affected gay men. However, as the years passed, women have emerged as another group hit by the HIV/AIDS epidemic. Globally, women living with HIV (HIV+) account for half of all people living with HIV and women living with HIV outnumber men living with HIV. Across the globe, transgender women are affected by HIV to a much greater degree than other groups. It is estimated that the proportion of transwomen living with HIV is 49 times higher than in the general adult population.
Who is at risk for HIV?
All women can get HIV, but your risk for getting HIV is higher if you:
- Have unprotected sex
- Have injected illegal drugs, either now or in the past
- Had sex with someone to get money or drugs in return or with someone who has traded sex for money or drugs
- Had sex with someone who has HIV
- Has sex with both men and women
- Injects drugs
- Had a blood transfusion between 1978 and 1985
Is HIV Different for Men and Women?
Until recently, little research had been done on women and HIV. While many questions remain unanswered, available information shows that HIV affects men and women differently in some ways:
- When women are first diagnosed, they tend to have lower amount of HIV in the blood compared to men who are newly diagnosed
- Women generally have lower CD4 cell counts than men with similar viral loads
- Women are more likely than men to develop bacterial pneumonia
- Women get thrush (a yeast infection) in their throats more often than men
Women tend to be diagnosed with HIV later in their disease than men and fewer women than men are getting HIV treatment. Women may delay getting medical care and treatment and choose not to disclose their HIV status for several reasons, including:
- Limited access to health care due to lack of insurance and/or transportation
- Unstable housing
- Fear of violence in the home
- The stigma associated with HIV
- Problems with substance abuse or addiction
- Lack of financial resources and/or social supports
- Taking care of everyone but themselves and not putting themselves first
Young women are at risk for HIV as well. According to a 2013 survey, only half of female high school students used a condom the last time they had sex. Only one in eight female high school students in the study had ever been tested for HIV. Younger women are more likely to have a sexually transmitted infection (STI). Having an untreated STI makes HIV transmission more often. An untreated vaginal yeast or bacterial infection can also increase the risk of transmission. This is because the infection brings white blood cells into the area. This is especially true for women, because small cuts on the skin of the vagina are hard to notice but may allow HIV to pass into your body. Teen girls and younger women are at higher risk for HIV infection than adult women, because their reproductive tract is still developing.
Pregnancy and HIV
With the advances in HIV care and treatment, many women living with HIV are living longer, healthier lives. As they think about the future, some of these women are deciding to have the babies they always wanted. Women living with HIV who want to become pregnant should discuss their plans with a health care provider.
More research is needed to determine how HIV progresses in women and how HIV drugs affect women’s bodies. However, it does seem that HIV drugs benefit women as much as men. By taking advantage of good health care and treatment as soon as you can, you greatly increase your chances of living a longer and healthier life for you and your loved ones.