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U.S. Fact Sheet

Women with HIV

January 1999

Contents:


Epidemiology

  • In 1997, 13,105 adult and adolescent women were newly diagnosed with AIDS in the U.S.(1)

  • The cumulative number of AIDS cases diagnosed in females and reported to CDC through June 1998 is 108,032. Of that number, 104,0256 (96%) are in females 13 and over. Of the total number of number of females who have been diagnosed with AIDS in the U.S. since reporting has begun, 87% have been between the ages of 20 and 49, with 9% of reported cases in women aged 50 and older.(2)

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  • The proportion of women within the total number of reported U.S. cases of AIDS has risen from 7% in 1985 to 22% in 1997.(1)

  • About one out of every three persons found to have HIV infection in the U.S. is a woman: recent figures show that women now account for 32% of all newly identified HIV positive cases in the 31 states that report new infections.(2)

  • African American women represented 60% of the 13,105 U.S. women reported with AIDS in 1997; 20% of the total number of reported AIDS cases were Hispanic; 19% were Caucasian, and less than 1% of the cases were diagnosed in Asian/Pacific Island women, and in American Indian/Alaska Native women.(1)

  • In 1997, the rates of newly reported AIDS cases in women by per 100,000 women of different race/ethnicity were as follows: 59 new cases of AIDS per 100,000 African American women, 22 cases per 100,000 Hispanic women, 5 cases per 100,000 American Indian/Alaskan native women, 3 cases per 100,000 Caucasian women, and 2 cases per 100,000 Asian/Pacific Islander women.(1)

  • Teens and young women now represent about half (49%) of all new HIV infections reported in young people from the ages of 13 to 24 (of a total of 2,535 new HIV infections in both males and females of this age group), from 28 reporting states during the period July 1997-June 1998.(2)

  • African American and Hispanic women accounted for 78% of all new adult and adolescent HIV infections in U.S. women (of a total 5,444 new HIV infections) reported from the 31 reporting states.(2)

  • The numbers of new cases of AIDS diagnosed in women and reported from July 1997 to June 1998 were highest in the following states: New York (3,064 new cases) Florida (1,484) New Jersey (819) and California (682).(2)

  • For the year 1997, the highest rates of AIDS per 100,000 women in states and territories were in the U.S. Virgin Islands, New York, Puerto Rico, New Jersey, Maryland, Florida, and Connecticut. Every state except Vermont reported some AIDS cases among women in 1997.(1)

  • In one recent study, disadvantaged young women in the District of Columbia were found to have the highest HIV prevalence of any other area, at 10.3 per 1,000, followed by Florida (9.8 per 1000), Maryland (9.1 per 1000), South Carolina (8.2 per 1000), and Louisiana (5.1 per 1000). These prevalence rates in each case were higher than the prevalence rates in young men.(3)

  • The number of new AIDS cases reported per year decreased 8% in women and 16% in men from 1996 to 1997.(1)

  • AIDS deaths declined among women by 32% from 1996 to 1997 compared to a decline of 44% in men. (A total of 4,682 adult and adolescent women died of AIDS in 1997, down from 6,912 in 1996, after reaching a high in 1995 with the AIDS-related deaths of 7,996 women).(1)

  • Overall, the United States accounts for 7% of all cases of HIV infection in the world.(4)

  • It has been estimated that about one of every three HIV positive people in the United States do not know they have HIV infection.


Transmission of HIV Infection

  • The most common mechanism of HIV infection among women in the United States is by heterosexual intercourse with a bisexual man or injection drug user. The percentage of reported AIDS cases in women attributed to heterosexual transmission has risen from 21% in 1985 to 38% in 1997.(5)

  • The risk of transmission of HIV infection per sexual contact, from man to woman, is approximately 0.05% to 0.15%. (The risk per contact from woman to man is from 0.03 to 0.09%).(5)

  • Over the past ten years, the proportion of cases among Hispanic women infected heterosexually has increased from approximately 30% to 60% of cases. HIV infection among African American women have also shown a significant increase in heterosexual transmission over the past decade.(1, 6)

  • The exposure categories for the 13,105 women diagnosed with AIDS in 1997 in the United States are the following:(1)

    • 38% - heterosexual contact

    • 32% - injection drug use (IDU)

    • 28% - other, not identified

    • 1% - transfusion

    • <1% - hemophilia

  • Over half (53%) of the nearly 52,000 adult and adolescent women living with AIDS in the U.S. were infected by heterosexual contact.(2)


Economic and Social Profile of HIV-Infected Women(7)

  • The majority of women with AIDS in the United States are unemployed, and 83% live in households with incomes less than $10,000 per year.

  • Only 14% of women with AIDS are currently married, compared to 50% of all women in the United States, aged 15-44 years. 23% of women with HIV infection live alone, 2% live in various facilities, and 1% are homeless.

  • Approximately 50% of women with HIV infection have at least one child less than the age of 15 years.


References

  1. HIV/AIDS Surveillance Reports*, Year-End 1997 Edition, Vol.9, No.2; Centers for Disease Control and Prevention, National Center for HIV, STD and TB Prevention Atlanta GA 30333; June 1998.

  2. HIV/AIDS Surveillance Reports*, Mid-year 1998 Edition, Vol.10, No.1; Centers for Disease Control and Prevention, National Center for HIV, STD and TB Prevention Atlanta GA 30333; December 1998. (Available in printed form from February 1999; available on web through CDC's website, http://www.cdc.gov; the URL for the Surveillance Report is: http://www.cdc.gov/nchstp/hiv_aids/stats/hasrlink.htm.)

  3. National Data on HIV Prevalence Among Disadvantaged Youth in the 1990's, Centers for Disease Control and Prevention, August 1998.

  4. HIV Insite.

  5. Treatment Strategies for HIV-Infected Women, ARHP Clinical Proceedings, October 1998, Association of Reproductive Health Professionals, 2401 Pennsylvania Ave NW, Suite 350, Washington, DC 20037; Tel: 202/466-3825; Fax 202/466-3826; Email: arhp@aol.com.

  6. A Closer Look at Trends by Race and Gender, from the CDC Report "Trends in the HIV and AIDS Epidemic, 1998" presented at the time of the 1998 World AIDS Conference.

  7. Levine, Alexandra, HIV Disease In Women.
*Note re: surveillance report information: Since HIV infection is not uniformly reported throughout the United States (not all states report HIV infection cases, unlike the reporting of AIDS cases) estimates of HIV infection are limited and difficult, and they do not precisely reflect the epidemic. Cumulative numbers of persons living with AIDS under-represents the number of living persons who have been infected with HIV disease because most infected persons have not yet progressed to AIDS, and many persons infected with HIV have not been tested or diagnosed. CDC estimates there currently are approximately a total of 650,000 to 900,000 Americans infected with HIV.


Services

  • Title IV of the Ryan White Act support the development of infrastructure to provide comprehensive care to children, youth and their families. Title IV projects facilitate linkages between comprehensive care and clinical research and support the participation of HIV infected women, children, adolescents, pregnant women and families in clinical research trials. Services are provided by projects at 225 Title IV sites in 25 states and territories. National Pediatric and Family HIV Resource Center, Newark, NJ, Ryan White CARE Act Title IV HIV Programs for Children, Youth, Women and Families: Directory: 1997-1998.

  • Medicaid is the largest single payer of direct medical services to 50% of all persons living with AIDS and up to 90% of those persons under 18 years of age living with AIDS. (Health Care Financing Administration [HCFA] HCFA's Maternal AIDS Initiative).

  • Of 18 million Medicaid-eligible women, approximately 32,000 have HIV infection; approximately 3,000 have HIV infection and are pregnant. (Health Care Financing Administration [HCFA] HCFA's Maternal AIDS Initiative).


Research

  • A 1998 study indicates that women with HIV infection have a 50 percent increased survival rate if they receive care at an experienced clinic instead of one with less HIV experience. Dr. Christine Laine of Jefferson Medical College in Philadelphia, PA, and colleagues examined the survival time of 887 HIV-positive women who visited 117 clinics in New York. The researchers found that 71 percent of patients enrolled in high-experience clinics were still alive 21 months after diagnosis, compared to 53 percent of those treated at less-experienced clinics. (From CDC National Center for HIV, STD and TB Prevention Daily News Summary, 3/9/98, from a report in the March 5 1998 issue of the journal AIDS)

  • A study of 1,075 HIV-positive pregnant women in Tanzania found that a single daily dose of multivitamins can improve the health of both seropositive women and their newborns. Study participants who took multivitamins had significantly fewer preterm births as well as fewer babies with low birth weights and fewer fetal deaths. Wilfert, C.; AIDS Care, October 1998

  • The Pediatric, Adolescent, and Maternal AIDS Branch - NIH (PAMA) Branch focuses on supporting and conducting research into the epidemiology, natural history, pathogenesis, transmission, and treatment of HIV infection and disease in infants, children, adolescents, pregnant women, mothers, women of childbearing age, and the family unit as a whole.

  • In a recent study in Malawi, HIV prevalence had built up to high levels in older age groups, but the bulk of new infections were occurring in younger women (Source: Taha et al. AIDS 1998 12:197-203). As infection rises in the general population, so does the likelihood of encountering a partner with HIV infection (especially an older partner) early in one's sexual career. Over time, then, new infections become increasingly concentrated in the youngest age groups.

  • St. Louis ME, Wasserheit JN, Gayle HD. Janus considers the HIV pandemic - harnessing recent advances to enhance AIDS prevention [Editorial]. Am J Public Health 1997;87:10-2.


For Further Reference or Assistance

  • CDC National HIV/AIDS Hotline: 1 800 344-AIDS (-2437). Confidential information, referrals, and educational material on HIV/AIDS. Available 24 hours a day, 7 days a week.


Fact sheet compiled by Catherine Briggs, MD MPH

Please feel free to send comments and suggestions about our "Women with HIV: A U.S. Fact Sheet" to ortegaes@umdnj.edu with a subject line "Women with HIV: A U.S. Fact Sheet."



  
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