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HIV IN WOMEN

As discussed previously, although women make up a relatively small percentage of those infected with HIV and those with AIDS itn the United States, they are one of the fastest-growing groups among the newly infected. Most often these are women who are at some risk for HIV such as those who use injection drugs and share works, or who have a sexual partner who is an injection drug user. Women often have a poorer prognosis than men, possibly because of inadequate access to health care.

Until recently, research into HIV and its clinical manifestations has focused on men, but we are now beginning to have a better idea of how HIV affects women. The treatment regimens for HIV are currently the same for women as for men (see the section on treatment), but there are differences between women and men with HIV infection. Women with HIV infection are more likely to have such AIDS-deflning illnesses as Candida (yeast) in the throat, recurrent bacterial pneumonia, and progressive multifocal leukencephalopathy. Men, on the other hand, are more likely to have such illnesses as Kaposi’s sarcoma, oral hairy leukoplakia, Pneumocystis carinii pneumonia, and prolonged herpes outbreaks.

Women with HIV infection and AIDS are also at high risk for gynecological problems. Infected women acquire cervical cancer more often than women without HIV and the course of the cancer can be much more aggressive. Therefore, women with HIV infection and AIDS should be screened for cervical cancer more closely (every six months) than other women (for whom annual Pap smears are recommended).The treatment of cervical cancer is the same for both groups. Frequent yeast infections can be a sign of HIV infection in otherwise healthy women, but the connection is by no means automatic (see “Fungal Infections”). In addition, women infected with HIV are more likely to have problems with their periods and to experience early menopause.

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