HIV 101














What Women Should
Know About HIV

Many of the treatment options and preventative measures as well as other aspects of the HIV virus are the same for anybody. But there are differences and concerns for women so knowing some basics can help women with the facts and offer some peace of mind.

Differences Between Women And Men

According to the U.S. Department of Health and Human Services, the following are the main differences women deal with in HIV diagnosis, treatment and concerns:
- Women often have gynecological conditions as a result of HIV infection. These can include persistent and difficult-to-treat vaginal yeast infections, pelvic inflammatory disease, cervical dysplasia (abnormal cell changes in the cervix, and an increased likelihood of developing cervical cancer.

- Women who are diagnosed with HIV should have a Pap smear and a pelvic exam as soon as possible. They should have a follow-up Pap smear 6 months later.

- Women may have concerns about pregnancy and childbirth--whether for a current pregnancy or for the future. It is best to talk with your HIV specialist about these concerns.

- Women are less likely to develop kaposi's sarcoma, a type of cancer that is a common opportunistic infection and an AIDS-defining condition.

- Women are often diagnosed later in the stages of HIV infection, so they can be more susceptible to opportunistic infections.

- Women often must be stronger advocates for themselves and their treatment when engaged in HIV care. Many times women face multiple barriers to care.

Are You At Risk?

Between 2005 and 2014, the number of new HIV diagnoses among women declined 40%. According to the Centers for Disease Control and Prevention (CDC) women are at risk of contracting the HIV virus and depending on lifestyle and other issues, some women can be at a very high risk. In a study conducted by the CDC, roughly 1-in-4 people diagnosed as being HIV positive are women and most new HIV diagnoses are attributed to heterosexual sex. African American and Hispanic women are disproportionately affected compared to women of other races and ethnicities. Of the total estimated number of women living with diagnosed HIV at the end of 2013, 61% (137,504) were African American, 17% (39,177) were white, and 17% (38,664) were Hispanics/Latinas. It’s also estimated that 15% of women who are HIV positive are unaware of their status.

You Should Know Some Risk Factors For Acquiring HIV If You Are Not HIV-Positive And Passing HIV If You Are HIV-Positive

-Women are more likely to get HIV during vaginal sex than men. These are some reasons why:

- The vagina has a larger area than the penis that can be exposed to HIV-infected semen.

- Semen can stay in the vagina for days after sex, while men are only exposed to HIV-infected fluids during sex. Semen left in the vagina means a longer exposure to the virus for women.

- Having untreated sexually transmitted infections (STIs) makes it more likely for a person to get HIV. This is especially true for women. Small cuts on the skin of the vagina are hard to notice but may allow HIV to pass into a woman's body.

--Many HIV-positive women with HIV-negative partners worry about passing HIV. Research shows in the United States, men pass HIV more easily than women do. But women can still pass HIV to uninfected partners -- both male and female -- through all kinds of sex. This is because HIV is in blood (including menstrual blood), vaginal fluids, and in cells in the vaginal and anal walls.

If you are HIV-positive, you can pass the virus at any time, even if you are getting treatment. But you may be more likely to pass the virus if:

  • You have a vaginal yeast infection or STIs
  • You have recently been treated for a vaginal yeast infection or STIs
  • You were recently infected with HIV
  • Your partner has an infection or inflammation

The best way to avoid passing any STI, including HIV, if you do have sex, is to always use a condom every time you have sex.

-It is rare, but it is possible for a woman to get HIV through sexual contact with an HIV-positive woman. Experts think this could happen if soft tissues, such as those in the mouth, come in contact with the vaginal fluid or menstrual blood of a woman infected with HIV. A lesbian or bisexual woman should know her HIV status as well as her partner's. That way, she can take steps to protect herself or others from HIV. You can lower your risk of getting HIV by using condoms every time you have sex with men or when using sex toys. Some suggest using dental dams to lower the risk of getting or spreading HIV through oral sex although, not much research has been done to prove that they are effective.

-Female partners of men who do not know that their partner is also having sex with one or more men. These women have a higher risk of getting HIV, especially if the male partner had unprotected sex with HIV-positive men.

Get PrEP Prevention Educated

In 2014 The CDC recommended new guidelines for the use of Pre-Exposure Prophylaxis or PrEP in HIV prevention. The guidelines requested that health care providers consider advising the use of anti-HIV drugs by uninfected patients who are at substantial risk of infection.

The recommendations states that PrEP can reduce HIV infection rates. When taken daily as directed, PrEP can reduce the risk of HIV infection by more than 90 percent.

The guidelines say PrEP should be considered for HIV-uninfected patients with any of the following indications:

-Anyone who is in an ongoing sexual relationship with an HIV-infected partner.

-A gay or bisexual man who has had sex without a condom or has been diagnosed with a sexually transmitted infection within the past six months, and is not in a mutually-monogamous relationship with a partner who recently tested HIV-negative.

-A heterosexual man or woman who does not always use condoms when having sex with partners known to be at risk for HIV (for example, injection drug users or bisexual male partners of unknown HIV status), and is not in a mutually-monogamous relationship with a partner who recently tested HIV-negative.

-Anyone who has, within the past six months, injected illicit drugs and shared equipment or been in a treatment program for injection drug use.

Of course, many recommend that you are best protected by using both PrEP and a condom for the most protection if you are engaging in high-risk sexual behavior.

PrEP is a single pill (single tablet HIV regimen) branded Truvada. Because it is so important and deserves much more space than we can give it here, please visit www.start.truvada.com for more information and possible financial assistance.

If you are HIV-positive and live in the United States, the chances your baby will be born HIV-positive is less than 2%.

Currently, there are fewer than 250 infants born each year in the United States with HIV, and in almost every case, it was the result of failure to follow established guidelines--often because the mother was non-compliant because of addiction to drugs.

Here are the procedures that have cut down the rate of mother-to-child transmission of HIV so dramatically:

1. Universal prenatal HIV counseling and testing.
In the United States today, expectant mothers are offered the opportunity to have an HIV test. Obviously, doctors can't do anything to keep your baby from being born with HIV if they don't know you have it yourself. So this is the universal first step.

2. Antiretroviral prophylaxis.
A complicated way of saying: Treating the mother with combination HIV therapy. Studies show that mothers who are taking HIV medications and have an undetectable viral load have a very low risk of passing along HIV to their babies. So doctors will often recommend that expectant women start HIV therapy to protect their babies. The higher your viral load, the greater the chance that you will pass on HIV to your child. The lower your viral load, the lower the danger of transmission.

3. Scheduled Cesarean Delivery.
A C-Section can protect your baby from exposure to your genital tract virus during passage through the birth canal. This is generally recommended for women who have a viral load greater than 1,000. Women who have viral loads below 1,000 have very low rates of infected babies, and a C-section doesn't seem
to make any difference.

4. Avoidance of breastfeeding.
A woman can give HIV to a baby who was born healthy through her breast milk. So, in the United States--where bottle-feeding is a safe and practical alternative--women with HIV (even those on HAART), are advised to avoid breastfeeding their children.

Is there anything else you can do to protect your child? Yes! Give up smoking, drinking and drugs--all of these can have a negative impact on your child. And take vitamins prescribed by your doctor that contain folic acid and calcium, which can reduce the rates of certain birth defects.

Of course, there is no absolute guarantee that you will have a healthy child--not for a woman with HIV or a woman who does not have the virus. But, if you follow your doctor's orders, the odds are good.

Get Tested
If you fall into one of the high-risk groups mentioned or recently engaged in high-risk behavior -- GET TESTED! If you are not HIV positive but have been exposed to any of the risk factors, get tested! The tests are fast, easy and in some cases free. The sooner you know your status and begin treatment, the better off you'll be.

Copyright 2018, Positive Health Publications, Inc.

This magazine is intended to enhance your relationship with your doctor - not replace it! Medical treatments and products should always be discussed with a licensed physician who has experience treating HIV and AIDS!