Infections with HIV, the virus that causes AIDS, have been rising faster in women than in men. The percentage of female infected adults and adolescents increased steadily, from 7 percent in 1985 to 18 percent in 1995. And although total deaths from AIDS declined by 12 percent overall in the first half of 1996, deaths among women with AIDS rose by 3 percent during the same period.

The disease disproportionately affects minority women. Although African-American and Hispanic women make up 21 percent of the country's female population, they account for about 75 percent of women diagnosed with AIDS. This does not mean that a person is at risk simply by being a member of a racial or ethnic minority group; rather, it reflects the higher numbers of minority populations in communities with a high incidence of HIV infection.

In this country, most women who now have AIDS became infected with HIV by injecting illegal drugs. But the rate of infection through heterosexual transmission has been rising dramatically. Of 13,996 women whose AIDS cases were reported between July 1995 and June 1996, 36 percent were infected through injection drug use and 40 percent through sex.

The Centers for Disease Control and Prevention reports that, "Many women in the United States are unaware they are at risk for HIV infection, and HIV-infected women often remain undiagnosed until the onset of AIDS or until a perinatally infected child [infected before or during birth] becomes ill."

What You Don't Know Can Hurt You

A woman may not realize she is at risk for HIV. For example, she may not know her sex partner uses or has used intravenous drugs or is bisexual or has had at-risk sex partners in the past. She may disregard symptoms that could serve as warning signals and therefore, not seek testing or treatment.

"Delayed diagnosis affects survival," says Theresa Toigo, associate commissioner for the Office of Special Health Issues in the Food and Drug Administration. "The late diagnosis of women has contributed to past reports that women's survival time is shorter than men's. It's not." If a woman is diagnosed at the same point in the disease as a man, her survival is, on the average, the same. But most HIV-infected women are from poor populations with poor access to health care, whereas many men with HIV are more affluent gay men from areas with better medical resources.

"Probably the biggest contribution that can be made to the survival of someone with HIV is to get them into early treatment," says Toigo.

Based on experience with the gay male population, it appears that education and awareness are important in stemming the tide of HIV infection. Early in the AIDS epidemic, gay men — who were then the hardest hit group — organized and conducted an extensive education program that proved effective in bringing many gay men into clinics for testing and treatment.

Federal, state, local, and nongovernment agencies are working together and individually to step up prevention efforts, improve diagnostic and treatment services, and establish community-based health education and risk-reduction programs for diverse populations, including gay and bisexual men, prostitutes, injection drug users, heterosexuals with multiple sex partners, women at risk, homeless people, and youth in high-risk situations, such as runaways and youngsters in shelters or detention centers. President Clinton in 1993 established the Office of AIDS Policy to coordinate all federal-level efforts against the epidemic. In addition, the National Task Force on AIDS Drug Development was established by the Secretary of Department of Health and Human Services to identify barriers to the rapid development of therapies for the treatment of AIDS. The task force has provided an opportunity for members of affected communities, the pharmaceutical industry, academia, and government agencies to engage in frank discussions about removing obstacles to AIDS drug development. These discussions have been reinforced by the President's Summit on AIDS in December of 1995 and subsequent meetings of the President's Advisory Council on AIDS, as well as Vice President Gore's meetings with the pharmaceutical industry.

It's expected that FDA's approval in 1996 of two blood tests will result in earlier diagnosis of HIV infection, especially among women and minorities. A home test kit, available over the counter, enables a person to obtain a blood sample at home and then send it, with identity protected, to a lab for analysis. Counseling is provided as part of the test system. Orasure Western blot is a laboratory test that doesn't require a blood sample. Rather, it requires a tissue sample that can be collected from between the gum and cheek.

Tags: HIV and AIDS, Women's Health

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