Women And Aids
Understanding the Issues of Women and HIV/AIDS Rachel Seldin, Colgate
University, Hamilton NY 13346 ABTRACT: Infection with the human immunodeficiency
virus (HIV) had emerged as a major health problem for women in the United
States. Family physicians can play an important role in the detection and care
of HIV-infected women. The epidemiology and natural history of HIV infection in
women were reviewed. HIV infection is now a leading cause of morbidity and
mortality among young women in the United States, particularly women of racial
and ethnic minorities. Most cases of acquired immunodeficiency syndrome (AIDS)
in women occur as a result of injection-drug use or heterosexual transmission.
Based on limited information, women and men appear to have similar AIDS-defining
conditions. Gynecological problems are common n HIV-infected women. Pregnancy
does not seem to be affected by early HIV infection, but women with advanced
disease might be at increased risk for obstetric complications. More women need
to be included in natural history studies and clinical drug trials. Early
awareness of HIV infection and better access to health care services are
required to improve the treatment and survival of HIV-infected women. KEYWORDS:
Acquired Immunodeficiency Syndrome (AIDS), Human Immunodeficiency Virus (HIV),
Pregnancy, Zidovudine (AZT), Vaginal Candidasis, Transmission Methods of
HIV/AIDS, Perinatal Transmission, Women and HIV INTRODUCTION: Acquired
Immunodeficiency Syndrome (AIDS) has been declared ‘the public health threat of
the century’ (1 cited in 2). The US Surgeon General has designated it as the
nation’s number one health priority (2). AIDS is a disease that affects the
immune system. The term immunodeficiency refers to the inability of the immune
system to function properly, thus making the individual susceptible to a variety
of infections not typically found in a healthy immune system (3). A syndrome is
a group of symptoms or illnesses originating from one cause. The main agent
causing AIDS is a retrovirus known as Human Immunodeficiency Virus (HIV). HIV is
the agent of a sexually transmitted disease that can also be contracted through
blood transfusions or IV drug use; the disease can also be passed on to a fetus
during pregnancy. When people are infected with HIV, they are not necessarily
also infected with AIDS.
A person is not infected with AIDS until HIV reduces
immune function to a certain level or when one or more serious illnesses related
to HIV occurs. (4) Everyone is at risk of contracting the HIV virus, although
women with HIV/AIDS face more difficulties living with this disease than do men.
HIV/AIDS women are of special interest because they are the major source of
infection of infants. Not only do they have to think about the effects on their
own lives, but also they must think about their infants if they choose to
conceive. In my paper, I will review the ways in which HIV/AIDS affects women
differently than men, through clinical issues and gynecological manifestations.
I will also discuss the virus itself and issues concerning HIV positive women
who are planning to conceive. WHAT IS AIDS? In early 1983, a team at the Pasteur
Institute in Paris, France led by Dr. Luc Montagnier first announced the
discovery of HIV (5). They originally named it LAV, or lymphadenopathy-associated
virus. However, it was not until the American team, led by Dr. Robert Gallo,
called the virus HTLV-3 or human T-cell lymphotrophic virus that both teams
collaborated and simplified it to just HIV (5). HIV can cause a range of
conditions, of which AIDS is the worst. For example, it can lead to persistent
swelling of the lymph nodes (5). Other people may have more serious symptoms but
still show no sign of AIDS. This condition is known as AIDS related-complex (
ARC) (5). Some of the symptoms of ARC include swollen glands, severe or chronic
diarrhea, severe fatigue, rapid unexplained weight loss, drenching night sweats,
fevers, and yeast infections, Although it can be serious, ARC is not fatal (5).
The cause of AIDS is not fully understood. There are other factors are involved
in the development of AIDS. Once a person tests positive to HIV, alcohol or drug
use, poor nutrition, high stress levels, frequent exposure to other disease
(especially sexually transmitted disease), have all been suggested to increase
the risk of developing full blown AIDS (5). HIV transmission can be tracked
accurately. However, anxiety surrounds AIDS because its transmission from one
person to another is not fully understood. Many people believe that it is
possible to get AIDS through, normal everyday contact with an infected person.
This is not the case. The majority of the people infected with HIV have
contracted it through sexual intercourse with an infected person (5). Bodily
fluids such as blood, semen, and vaginal secretions all may contain the virus.
Using a condom can decrease the risk of contacting the HIV virus during
intercourse with an infected partner. Another method of infection is through
blood transfusion during surgery. A person may receive untested, infected blood,
therefore containing the disease. Through mid 1992, 2% of HIV infected adults
and 12% of HIV infected children were infected with HIV via blood transfusion
(15).