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April 8, 1997

Heterosexual HIV Transmission:

12 to 30 Times Greater in Women than Men

by Paul H. Carlson, RN

The latest available statistics indicate that women who became infected with HIV (Human Immunodeficiency Virus) through heterosexual transmission represent 37% of all women infected with HIV, while only 3% of men with AIDS acquired HIV by heterosexual transmission.

The rate of heterosexual transmission of HIV/AIDS is increasing. The percentage of women infected in this manner far surpasses the percentage of men, and women represent the fastest growing group of people with HIV/AIDS. At least half of HIV cases in women have been reported since l989, again indicating that infection among women is increasing. AIDS is no longer a disease of gays and I.V. drug users. It is now also a disease of women and older adults.

Women are now being infected by heterosexual transmission at a rate estimated at up to 30 times that for men, up from just over 12 times the rate for men only a few years ago.

Women are biologically more vulnerable than men, so women are at greater risk than men for contracting HIV via heterosexual transmission. Sperm release a higher dose of HIV than vaginal fluids, and vaginal and cervical epithelia (tissues) are directly infected, often due to abrasion during intercourse. In addition, the menstrual cycle causes vaginal pH to be less acidic, which creates a more hospitable environment for HIV. Decreased immune functioning and lack of awareness of their particular age-related risk factors also contribute to the increasing rate of HIV infection in women over age 50.

A March l997 study reported that people aged 55 or older develop AIDS more rapidly, are hospitalized more often for both HIV-related and non-HIV-related reasons, and have significantly lower survival rates than younger people. In that same study of 43 infected patients aged 55 or older, none of them had sought HIV testing on their own. This suggests that the older adult population does not recognize their risk for HIV/AIDS.

Prevention education information, targeting older adults and health care professionals, is being presented to various nursing and health care associations and societies, and other groups throughout Alabama by the author and Marianne McCrory, RN MS. The Southeast AIDS Training and Education Center (SEATEC) and Emory University in Atlanta, Georgia have recently awarded partial funding to these registered nurses to enable these programs to continue. Funding was secured with assistance from the Mobile County Health Department and the Alabama Department of Public Health. Roma Hanks,Ph.D., of the University of South Alabama, and Cindy Nelms,RN, Executive Director of Mobile AIDS Support Services (MASS) provided the initial opportunity for our conducting the gerontological nursing research that led to the development of these educational programs.

Paul H. Carlson, Ph.D. RN is a full-time student in the Master of Science in Nursing program in the Department of Community and Mental Health Nursing, Mid- Level Management Track, at the University of South Alabama.

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