The impact of AIDS on women is growing rapidly, particularly among African American women and increasingly among Latinas. In 2003, women accounted for 26% of reported AIDS cases, of which 63% were African American and 18% were Latinas.1 As a group, women were 30% of all reported HIV infections in 2003. Most women become infected through vaginal sex (75%), followed by injection drug use (25%).2
Some women, including those who suspect that their partners are at-risk for HIV infection, may be reluctant to discuss condom use with their partners out of fear of emotional or physical abuse or the withdrawal of financial support.5 Furthermore, some fear their partners may interpret a positive HIV result or the simple act of testing as a sign of infidelity, which could result in relationship problems, abuse and violence.4 Many women are infected by male partners without having any awareness of being at risk of infection and are often unlikely to seek testing until symptoms appear.
Lack of awareness of women's risk of HIV infection -- even among health care providers -- often means that women are tested and diagnosed later in their infection. Some women find out their status during pregnancy, often with limited counseling and education.
Until recently, the desire to have children posed a unique dilemma for HIV-positive women and their partners. However, due to the availability of antiretroviral treatment in the U.S., the risk of transmission during pregnancy has almost been eliminated.3 Nonetheless, some women don't benefit from treatment because they lack access to affordable medical care and appropriate testing and counseling early in the pregnancy. For many, particularly low income women, testing for HIV may not be a priority or easily accessible4 as their time is occupied by taking care of their family and homemaking, in addition to holding a paid job.
Research has shown that many women face gender-specific factors that explain their risk-taking behavior when having sex with men. For example, some feel they have no control over their partner's use of condoms and some fail to protect themselves for HIV because they are using other contraceptive methods.4 In addition, the need for intimacy and trust and lack of assertiveness may keep women from maintaining safe sex practices.