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Ask the Doctor: Women and HIV -- An Overview

March 20, 2012

Ask the Doctor: What Is HIV-Related Anal Cancer?

Every month HIV specialist Theresa Mack, M.D., M.P.H. -- an associate medical director at St. Luke's Medical Group in Harlem, N.Y. -- will answer your most pressing HIV/AIDS questions.

March 10 marked National Women and Girls HIV/AIDS Awareness Day, a nationwide observance of the impact of the disease on women and girls. Although HIV/AIDS doesn't discriminate, women face unique challenges when it comes to prevention and care.

Black women are particularly affected by HIV/AIDS:

  • African American women represent 57 percent of new HIV infections among women, according to the latest statistics from the Centers for Disease Control and Prevention.
  • HIV is the third leading cause of death (pdf) among Black women between 25 and 44 years of age.
  • Eighty-five percent of new cases among women are due to unprotected heterosexual transmission.

Women who are at higher risk of becoming infected include the following:

  • Those who have experienced domestic violence or sexual abuse.
  • Those who engage in injection drug use or substance abuse.
  • Those with mental-health issues.
  • Those who have a sexually transmitted disease.

Caring for Others, Ignoring Ourselves


Women take care of everyone but themselves. They often delay HIV testing and as a result are likely to be diagnosed at a more advanced stage than men are. Many women learn that they have HIV when they're pregnant or after they've been admitted to the hospital for an acute illness. However, since with effective treatment HIV is no longer a death sentence, early HIV testing is crucial to managing the disease.

Why do women fail to get tested and postpone treatment once they know they're HIV positive?

Stigma: Many women with HIV/AIDS don't disclose because of denial and shame.

Poverty: Lack of health insurance, not having a regular doctor, difficulties obtaining child care, transportation challenges and other realities of daily life often keep poor women from obtaining the care they need.

Health-care disparities: For a wide variety of reasons, Black women and other women of color often receive substandard care.

Myths and misconceptions: Some women believe that their lifestyle precludes them from being vulnerable to HIV infection. But if you engage in unprotected sex, HIV transmission is possible if bodily fluids are exchanged. It's important to know your partner's status as well as your own. Since your partner may not be aware of his or her status, the best way to protect yourself is to get tested together. If you are practicing monogamy, make sure it is mutual. And while no cases of female-to-female sexual transmission (pdf) of HIV have been documented, even women who have sex with women could be at risk of transmitting or acquiring the disease.

Tools such as condoms and dental dams can act as barriers to prevent bodily fluids from being exchanged. And while they're not widely known about, female condoms can empower women to take HIV prevention into their own hands. If a condom breaks or your believe you've been exposed to HIV, you should go immediately to your doctor, a clinic or an emergency room to obtain a 20-minute, rapid HIV test and request postexposure prophylaxis: ARV medications to prevent you from getting HIV. In the future, researchers hope that microbicides -- medications that people could apply to their vagina or rectum before having sex -- may help prevent HIV.

Women who live with HIV experience different manifestations from men. Among them are these:

  • Frequent yeast infections that are difficult to treat.
  • Severe pelvic inflammatory diseases.
  • Increased risk of cervical dysplasia -- precancerous changes in the cervix -- as well as cervical cancer.
  • More frequent and severe occurrences of bacterial vaginosis, gonorrhea, chlamydia and herpes.

These women should be routinely evaluated for conditions such as diabetes, kidney disease, cancer and obesity in addition to being treated for HIV.

Finally, women living with HIV can have an HIV-negative child if they take ARVs throughout pregnancy. However, experts advise against breast-feeding because of the risk of HIV transmission to the child.

Tamara E. Holmes is a Washington, D.C.-based journalist who writes frequently about emotional health and wellness.

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This article was provided by The Black AIDS Institute. Visit Black AIDS Institute's website to find out more about their activities and publications.
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