Women, HIV and AIDS

Globally, HIV/AIDS is the leading cause of death among women of reproductive age. In the Caribbean, the development of HIV/AIDS has been described as an “epidemic” in recent years. How can individuals and in particular women protect themselves? Business Editor Lindsey Turnbull attended a special seminar on the subject during the Medical and Nursing Conference 2010 held earlier this year and reports.

H. Barry Baker is an MD with Baptist Health and gave a detailed lecture on women, HIV (human immunodeficiency virus) and AIDS (acquired immunodeficiency syndrome) at the conference. He said that contrary to the initial reporting of HIV/AIDS when the virus first reared its ugly head back in the 1980s, the virus is not a “gay plague” and can be contracted by anyone who either has unprotected sex with an infected person or who comes into contact with an infected person’s blood. It is estimated that 56,300 people in the US are newly infected with HIV annually. 71 per cent of women diagnosed with HIV in the US in 2005 (the most recent figures), contracted the disease through heterosexual sex.The HIV virus which later causes full blown AIDS is also found in the breast milk of an infected woman. AN infected woman can also pass on the HIV virus during pregnancy and delivery.

Women more at risk
Women are twice as likely to contract HIV, which causes AIDS if they have unprotected sex with an infected man as compared to a man having unprotected sex with an infected female. It is therefore vitally important that women are properly educated on how to protect themselves, particularly as they can pass on the infection to their children. Baker explained why women are more susceptible to contracting the virus than men:
 
“The lining of the vagina provides a large area which can be exposed to HIV-infected semen,” he said. “Semen has higher levels of HIV than vaginal fluids and more semen is exchanged during sex than vaginal fluids,” he added.
 
In Sub-Saharan Africa women constitute 59 per cent of all people living with HIV/AIDS and among young people aged 15 to 24 the HIV prevalence rate for young women is almost three times that of men.

In the US women account for more than one in four new HIV/AIDS diagnoses and deaths caused by AIDS and the proportion of AIDS diagnoses reported among women has more than tripled since 1985.

Baker said the Caribbean has also seen an alarming increase in the number of HIV-infected women and again the main mode of HIV transmission is through heterosexual sex. Young women in the Caribbean are approximately 2.5 times more likely to be infected with HIV than young men.

According to Dr Baker, the rise in commercial sex has been identified as one of the key factors in the Caribbean HIV epidemic. He highlighted a study of HIV prevalence among female sex workers in Georgetown, Guyana, which showed that 30.6 per cent were infected with HIV.

“It has been reported that men will still pay more money for unprotected sex with a sex worker,” Baker stated. “This means that sex workers are not only at risk of becoming infected with HIV, but that if they are already infected they can pass the virus on to their clients.”

The doctor also highlighted the vulnerability of African-American women, stating that their HIV prevalence rate was nearly 18 times that of white women.

“AIDS is the leading cause of death for African-American women aged 25 – 24,” he stated.

Globally, the statistics do not improve when it comes to women and HIV/AIDS.

Worldwide, women constitute half of all people living with HIV/AIDS,” he explained. For women in their reproductive years (15 to 44) HIV/AIDS is the leading cause of death and disease worldwide.

The symptoms
Primary symptoms include a flu-like illness within a week to two months after exposure, with fever, headache, tiredness and enlarged lymph nodes. “Most primary infections go unrecognised,” Baker said. “More severe symptoms may not appear for another 10 years or more.”

Women who have HIV can also have additional symptoms such as vaginal yeast infections, other sexually transmitted diseases such as gonorrhea, as well as the HPV virus, abnormal PAP smears and infections of the reproductive organs as well as menstrual cycle changes, such as periods stopping.

As the infection progresses people develop swollen glands, fever or seats, weight loss, fatigue, decreased appetite and/or diarrhea and opportunistic infections such as fungal or viral diseases. 

Education is key
Worryingly, Baker said only 20 per cent of young women aged 15 to 24 can correctly identify ways of preventing HIV transmission, thus much more education needs to be undertaken if women are to protect themselves. Also, in low and middle income countries only one third of pregnant women are offered services to prevent mother-to-child transmission of HIV.

Baker identified that education does work, highlighting the decline in HIV infections among female sex workers in Haiti who had attended voluntary counseling. “This decline has been attributed to better education and knowledge about HIV prevalence,” he said.

There is a tremendous volume of drugs currently available to doctors to help slow the development of the HIV virus in infected people and thus slow down the development of full-blown AIDS. Baker highlighted many different approaches that doctors should take depending on the circumstances of their patient.  

“Practicing the ABC of prevention is the best way to avoid contracting HIV,” Baker said. “A stands for abstinence, i.e. no sexual contact or sharing of needles or other drug-related materials; B stands for Being faithful, i.e. remaining in a relationship where each individual has no other sexual partners and C stands for condoms. That means using a condom correctly and consistently ever time you have sex.”

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Barry Baker

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