National Women and Girls HIV/AIDS Awareness Day

Today, we pause to commemorate the third annual National Women and Girls HIV/AIDS Awareness Day and to recognize the female face of HIV/AIDS in America. Since the epidemic began in the early 1980s, more than 181,000 women and girls in the United States have been diagnosed with AIDS, and an estimated 86,000 have died with the disease.

In some parts of the world, HIV/AIDS predominately strikes women; globally, approximately half of all people living with HIV are female. Although that is not the case in the United States, women represent more than a quarter of all new annual HIV/AIDS diagnoses in this country. In 2005, nearly 10,000 U.S. women and adolescent girls (13 years of age and older) were diagnosed with HIV/AIDS.

HIV/AIDS disproportionately affects women of color in the United States. For example, in 2004 AIDS was the leading cause of death for black women ages 25 to 34. The following year, African-Americans accounted for roughly two-thirds of the nearly 127,000 U.S. women living with HIV/AIDS, even though only 13 percent of U.S. women are African-American. For Hispanic women living in the United States, HIV/AIDS is also a significant health issue. In 2005, Hispanic women were diagnosed with AIDS at more than five times the rate of white women in the United States.

Sex with an HIV-infected male partner is the leading mode of HIV transmission to women and adolescent girls. Approximately 80 percent of new female HIV/AIDS cases diagnosed in 2005 in the United States arose through heterosexual sex, and surveys suggest that many of the men involved did not know they were infected with HIV. It is crucial for women to know both their own HIV status and the HIV status of their sexual partners. The National Institute of Allergy and Infectious Diseases (NIAID), part of the National Institutes of Health (NIH), strongly endorses testing for HIV during routine medical care for adolescents, adults and pregnant women, as recommended by the U.S. Centers for Disease Control and Prevention. The early diagnosis of HIV not only has the potential to help prevent transmission by motivating infected people to modify their behavior, but also creates the opportunity to start treatment promptly, control the virus, make informed choices about childbearing and prolong life.

Sharing syringes and other equipment for injecting illegal drugs is the second most common mode of HIV transmission to American women, directly accounting for approximately one in every five new female HIV/AIDS cases in 2005.3 Injection drug use indirectly promotes HIV transmission as well: Since the AIDS epidemic began, at least 50 percent of all AIDS cases among women have been attributed to either injection drug use or sex with partners who inject drugs.

Tragically, some women find themselves in situations in which they lack the power to protect themselves from sexual transmission of HIV. They may be forced into sex, their male partners may refuse to wear condoms, or their partners may prevent them from using female condoms. NIAID supports a variety of research designed to develop new HIV prevention tools specifically for women. One priority research area is the development of safe, effective and acceptable microbicides -- gels, creams or other substances that women could utilize before sexual intercourse to prevent the transmission of HIV and other sexually transmitted infections.

NIAID also funds research investigating gender-specific differences in HIV/AIDS progression, complications and treatment, as well as research to prevent HIV transmission from an infected mother to her baby -- an area in which scientists have made great strides.

Still, there is much work to be done to protect women and girls from becoming infected with HIV. As a global community, we must correct the gender-based inequality that places many women at increased risk. Nationally, we must dramatically lower the rates of HIV/AIDS among racial and ethnical minorities. Women can take control of their health by getting routine HIV testing, avoiding illicit drug use and, when possible, learning their partners' HIV status and using protection during sex. These behavioral changes combined with scientific and socioeconomic advances will help reduce the vulnerability of all women and girls to this terrible disease.

Dr. Fauci is director of the National Institute of Allergy and Infectious Diseases at the National Institutes of Health in Bethesda, Maryland.