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AIDS And Women

How Do Women Get AIDS?

Sunday, April 21, 2013 - 14:50

Contributing Author: Guy Slowik FRCS

HIV infection is spread in three ways:

However, there is much misunderstanding about the ways in which HIV infection is not spread.

About one out of every three people in the U.S. infected with HIV, the virus that can lead to AIDS, is a woman. In the U.S., most HIV-infected women become infected during sex with an HIV-infected man or while using HIV-contaminated needles and syringes for injection drugs.

Nice To Know:

According to a 1999 survey, of the women who were diagnosed with HIV infection in the previous year:

  • 13% were infected through injection drug use.
  • 36% were infected through having sex with men, including injecting drug users, bisexual or heterosexual men, or men with hemophilia.
  • Less than 1% were infected from receiving blood transfusions or treatment with blood components or tissues containing HIV.
  • In about half of these women, the cause of infection was not reported or identified.

In some areas of the world, including countries in Africa and Asia, most women are infected through sex with heterosexual men.

Sexual Intercourse

HIV is spread most commonly by sexual contact with an infected partner. The virus can enter the body through the lining of the vagina, penis, rectum, or mouth during sexual relations.

Sexual activities that can result in HIV infection include:

  • Sexual intercourse
  • Anal sex (heterosexual or homosexual)
  • Oral sex (heterosexual or homosexual)

Need To Know:

Q: Can HIV be spread through kissing?

A: Although studies have found tiny amounts of HIV in the saliva of some people with HIV, researchers have found no evidence that HIV is spread to other people through kissing. However, the CDC recommends against "French" or open-mouthed kissing because of the possibility of contact with blood if the people kissing have any cuts or sores in the mouth.

Direct Contact With Infected Blood

HIV can be spread through direct contact with infected blood:

  • Through injected drugs. HIV frequently is spread among users of illegal drugs that are injected. This happens when needles or syringes contaminated with minute quantities of blood of someone infected with the virus are shared.
  • In a health-care setting. Transmission from patient to health-care worker or vice-versa - via accidental sticks with contaminated needles or other medical instruments - can occur, but this is rare.
  • Through a blood transfusion. Prior to the screening of blood for evidence of HIV infection and before the introduction in 1985 of heat-treating techniques to destroy HIV in blood products, HIV was transmitted through transfusions of contaminated blood or blood components. Today, because of blood screening and heat treatment, the risk of acquiring HIV from such transfusions is extremely small.

From An Infected Mother To Her Unborn Child

Women can transmit HIV to their fetuses during pregnancy or birth. Approximately one-quarter to one-third of all untreated pregnant women infected with HIV will pass the infection to their babies.

A pregnant woman can greatly reduce the risk of infecting her baby if she takes the anti-HIV drug AZT (also called zidovudine) during her pregnancy. Because the risk of transmission increases with longer delivery times, the risk can be further reduced by delivering the baby by cesarean section, a surgical procedure in which the baby is delivered through an incision in the mother's abdominal wall and uterus.Combining AZT treatment with cesarean delivery can reduce the infection rate to between 1% and 2%.

HIV also can be spread to babies through the breast milk of mothers infected with the virus.

  • Women who live in countries where safe alternatives to breast-feeding are readily available and affordable can eliminate the risk of transmitting the virus through breast milk by bottle-feeding their babies.
  • In developing countries, however, where such safe alternatives are not readily available or economically feasible, breast-feeding may offer benefits that outweigh the risk of HIV transmission.

How Is HIV Infection Not Spread?

Research indicates that HIV is NOT transmitted by casual contact such as:

  • Touching or hugging
  • Sharing household items such as utensils, towels, and bedding
  • Contact with sweat or tears
  • Sharing facilities such as swimming pools, saunas, hot tubs, or toilets with HIV-infected people
  • Coughs or sneezes

In short, studies indicate that HIV transmission requires intimate contact with infected blood or body fluids (vaginal secretions, semen, pre-ejaculation fluid, and breast milk). Activities that don't involve the possibility of such contact are regarded as posing no risk of infection.

Need To Know:

Q: Is it safe to share a household with an HIV-infected person?

A: Studies of families of HIV-infected people have found that HIV is not spread through sharing utensils, towels, bedding, or toilet facilities. Behaviors that increase the likelihood of contact with blood from an HIV-infected person, such as sharing a razor or toothbrush, should be avoided.

Teenage and Young Adult Women

Teenage and young adult women now make up half of all new HIV infections reported in people 13 to 24 years old. Among U.S. adolescent AIDS cases, the number of females represented tripled from 1987 to 1994.

Many American teenagers are engaging in behaviors that may put them at risk of acquiring HIV infection, other sexually transmitted diseases (STDs), or infections associated with drug injection, according to CDC surveys of high school students. Those behaviors include:

  • Having premarital sex
  • Using alcohol or drugs when they had sex, which may increase the likelihood of having unprotected sex
  • Using injected illegal drugs

How To Information:

Public health experts suggest the following measures to help prevent HIV infection in young women:

  • Sex education that includes information about AIDS and STDs.
  • Access to safe sex products, such as condoms.
  • Availability of understanding adults to consult, including parents, teachers, guidance counselors, healthcare professionals, and spiritual counselors such as ministers, priests, and rabbis.

Middle-Aged and Older Women

Eleven percent of all new U.S. AIDS cases are now in people over the age of 50. In the last few years, new AIDS cases rose faster in middle-aged and older people than in people under the age of 40.

In older women, sexual activity has been the most common cause of HIV infection, followed by infection from a blood transfusion before 1985. (U.S. blood banks began testing all donated blood for the presence of HIV in 1985. Today, there is little danger of getting HIV from transfusions in countries with good HIV blood screening programs.)

Need To Know:

Older women may not consider the possibility that they are HIV-infected because they don't belong to a group commonly considered "at risk." Furthermore, older women, unlike their younger counterparts, have not had the opportunity to learn about HIV in sex education classes.

Special concerns about HIV and AIDS in older women include:

  • Faster disease progression. There is an age-related decline in the immune system's disease-fighting ability. Older women with HIV usually become sick and die sooner than younger HIV-infected women.
  • Diagnostic delays. Health professionals may have a more difficult time recognizing AIDS in older women because early symptoms - fatigue, confusion, a loss of appetite, and swollen glands - also are found in other illnesses common in older people.
  • Treatment delays. Delays in diagnosis may mean that older women are not receiving timely treatment with medications to slow progression of the disease and prevent opportunistic infections.
  • Drug interactions. Medications commonly used by older women, such as blood pressure drugs or hormone replacement therapy, can interact with drugs used to treat HIV and AIDS. To avoid such interactions, a physician should be made aware of all medications that a patient with HIV infection is taking.

Older women should educate themselves about behaviors that put them at risk for HIV infection and measures they can take to avoid becoming infected.

Women in Poverty

Demographic studies have shown that a disproportionate number of women diagnosed with HIV and AIDS, both in the United States and abroad, are economically disadvantaged. Poverty increases a woman's vulnerability to HIV infection. Unemployment and low salaries perpetuate the cycle by limiting access to adequate health care for the disease.

Poverty and injection drugs are importance forces driving the spread of HIV in women the United States, particularly in poor communities. This is because:

  • Many women who acquire HIV infection sexually are infected through sex with an injection drug user.
  • Female sex workers (prostitutes) generally have no knowledge of their clients' HIV risk factors and are often unwilling or unable to insist on condom use.
  • Female sex workers (prostitutes) often are exposed to violence, coercion, and abuse, further preventing them from being able to protect themselves from HIV infection.

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