The Impact of HIV on Women

Woman looking upset
PeopleImages/Getty Images

While HIV does not discriminate between women and men, there are considerable differences in risk and symptoms of HIV in women. According to the Centers for Disease Control and Prevention, women account for 23 percent of the HIV infections in the U.S. Of those diagnosed, less than half are linked to care, while fewer than one in three is able to maintain an undetectable viral load indicative of treatment success.

The figures become even more concerning when comparing women by ethnic groups. African American women, for example, are today the fourth highest risk group overall and are nearly five times more likely to have HIV their male counterparts.

Moreover, women of color account for 50 percent of all new infections in people between the ages of 13 to 19 years, meaning that they're being infected at a far younger age than the men who infect them.

As such, HIV is today the seventh leading causes of death for African American and Latino women between 25 and 44.

Vulnerabilities in Women

There are vulnerabilities to HIV that are entirely unique to women and account for the many of the differences in infection rates between men and women worldwide. They include:

  • Biological vulnerabilities place awomen at greater risk of HIV due to the larger surface area of the vagina and cervix. This alone provides easy access for HIV through delicate mucosal tissues that line the female genital tract. As a result, women are twice as like to get HIV from sexual intercourse than their heterosexual male partner.
  • Gender inequities can disempower at-risk women by stripping them of sexual consent and the right of self-protection. Inequity in employment and education further exacerbate these issues, making women more reliant on financial support from men who may be abusive or even violent.
  • Racial disparities can further compound the issue with high rates of poverty, incarceration, and injecting drug use fueling the epidemic (particularly in African American communities where HIV rates are high). Failures in public health and lack of integrated HIV services drive many away from accessing the care they need.
  • Sexually abused women are more likely to engage in risky behaviors including multiple sex partners, condomless sex, or exchanging sex for drugs.
  • Sexually transmitted infections such as syphilis and gonorrhea are often difficult to diagnose in women, placing them at higher risk of HIV due to the open sores or lesions that are frequently missed.

Moreover, women are more likely to avoid or delay medical care due to financial constraints while sacrificing their own medical needs for those of their children.

What Can Be Done

A number of initiatives have been put in place to address the needs of women at risk of HIV. These include targeted campaigns aimed at women of color that age-appropriate and culturally sensitive.

From a medical standpoint, millions have been spent to research and develop topical microbicides that may provide "invisible" protection from HIV if intimate partners refuse to use condoms. Recent attempts have been made to renew interest in the female condom by improving the design and comfort of the device.

For women diagnosed with HIV, efforts have been made to integrate reproductive health service with HIV-specific care to ensure that infections are detected and women are retained in care.

Sources:

Abdool Karim, Q.; Abdool Karim, S.; Frohlich, J. et al. "Effectiveness and Safety Tenofovir Gel, an Antiretroviral Microbicide, for the Prevention of HIV Infection in Women."Science. 2010; 329(5996):1168-74.

Centers for Disease Control and Prevention. 'Monitoring Selected National HIV Prevention and Care Objectives by Using HIV Surveillance Data. "  HIV Surveillance Supplemental Report. 2016; 21(4):1-86.