You're not a gay man. You're not an intravenous drug abuser. You're a woman who doesn't sleep around or do drugs. Why should you worry about getting AIDS?
"The first teen-ager I had with AIDS was a delightful girl. You'd never think she was at risk. She was from a stable family. She had one sexual partner," said Gale Cromwell, a nurse practitioner with the University of Maryland's Adult AIDS Clinic.
"At the beginning of the epidemic, it was mainly drug users and gay men -- if you were involved with them, you were within the circle of risk. Now, the virus has clearly moved into the general population. We have lawyers, nurses, a Getty heiress even," said Denise Rouse, director of D.C. Women's Council on AIDS, referring to Aileen Getty, a granddaughter of Jean Paul Getty. "Now we're talking, we're all at risk."
The growing number of women infected with HIV, the AIDS virus, was dramatically illustrated recently at both political conventions, when Mary Fisher and Elizabeth Glaser took to the stage, respectively, in Houston and New York as personal witnesses to how HIV crosses all gender, sexual, racial and socio-economic boundaries.
Ms. Fisher and Ms. Glaser are not entirely representative of women with AIDS because the largest group, half of them, contracted the virus through intravenous drug use. Yet their speeches served to highlight what many health professionals see as a long-ignored subset of the HIV-positive population.
"Women still are not getting the attention they deserve," said Dr. Helen Rodriguez-Trias, a California-based physician and president-elect of American Public Health Association. "But it's become evident in the past two, three years that women are the fastest growing group."
While men with AIDS still greatly outnumber women with AIDS, female AIDS cases are growing at a higher percentage than male AIDS cases. For example, the number of women with AIDS jumped 15 percent from 1990 to 1991; in the same time period, the number of men with AIDs increased less than 4 percent.
That is linked in part to a shift in how people are contracting HIV: Although the largest transmission category remains male homosexual or bisexual contact, heterosexual transmission in recent years has shown the fastest increase. Last year, for example, the number of men contracting the virus from homosexual or bisexual sex actually dropped from the year before, while the number of people who contracted the disease from heterosexual sex went up 21 percent.
And that is particularly bad news for women because they more often contract the virus through sex with men than the other way around, according to statistics.
Additionally, AIDS statistics are worrisome because of the time lapse involved, researchers say.
"When you're looking at AIDS statistics, you're looking at something that happened five years ago," said Liza Solomon, a Johns Hopkins School of Public Health researcher who recently launched one of the first major studies on women and HIV infection. "For an epidemic that's only 11 years old, five years ago is another era."
Luana Clark of Baltimore is perhaps among the most typical of the women currently infected with the virus.
"I was 11 years old when I first stuck a needle in my arm," said Ms. Clark, who is now 40 and recently celebrated her seventh "anniversary" of recovery from drug use. More than half of the 717 Maryland women who have contracted AIDS since 1981 were intravenous drug users.
But despite her years of intravenous drug abuse, she never gave a thought about contracting HIV -- "Addicts don't think like that; they only think about how they're going to get the money for the next time" -- and only discovered she was infected after her boyfriend died of AIDS about five years ago. She said her infection has not yet developed into AIDS.
As an educator for the Health Education Resource Center (HERO), an AIDS resource center in Baltimore, and a volunteer active in several support groups, Ms. Clark has devoted much of her energy to helping other women who are HIV-infected.
L In part, the work is "my defense mechanism," Ms. Clark said.
"I have a personal life only sporadically. If I see a relationship developing into something where I'll have to disclose [my HIV status], where I would have to accept whatever reaction comes from that, I cut it off," said Ms. Clark, who is the mother of two grown children and currently is caring for a 14-year-old whose mother died of AIDS. "Right now, it's hard for me to accept I'm a time bomb waiting to go off. I've accepted it, but for the people who love me and who I'll have to leave behind -- my son, my daughter, a lover -- I haven't accepted that for them yet."
She advocates greater attention to the different medical and social problems women experience when it comes to AIDS.
"What happened to Joe doesn't mean it will happen to Mary," Ms. Clark said.