Human Immunodeficiency Virus and its Relationship to Women

Abstract

In North America and most of Europe, human immunodeficiency virus (HIV) currently largely affects men, whereas in Africa and most of the rest of the world the sexes are approximately equally affected. The pattern in Westernized countries ?ppears to be changing; women are now an Increasing proportion of new cases l- 5• HIV infection in women differs from that in men in some of the clinical manifestations and in psychosocial aspects, but, of most importance, is a w~man's ability to pass the infection to her unborn child. It has been estimated that, by 1991, the majority of new AIDS cases, worldwide, will be in children 6. Most of these will have been infected by their mothers. TRANSMISSION Heterosexual transmission accounts for the vast ~ajority of cases of HIV infection worldwide. This IS the predominant mode of spread in developing countries. In developed countries, such as the USA, by contrast, up to 52% of womenhave been infected through sharing intravenous aquipment''. These patterns are not distinct: heterosexual transmission occurs amongintravenous drug users (IVDUs) too, and since about two-thirds of IVDUs are male, and m~inly heterosexual, the majority of their partners will be women. Secondary spread beyond this may occur so that women on the fringes of drug culture m~y be at risk of acquiring HIV heterosexually WIthout themselves being drug users. This seems to J:'e the case, especially in the inner cities of the l!mted States'', whereas in UK, there is as yet httle evidence of spread outside recognized risk groups4,9,1O.