Women must be more aggressive in protecting themselves from AIDS


December 08, 1992|By Dr. Genevieve Matanoski | Dr. Genevieve Matanoski,Contributing Writer

Alarming statistics from the Centers for Disease Control and the Baltimore City Health Department show that acquired immune deficiency syndrome (AIDS) is the leading killer of Baltimore men and women of all races between 25 and 44.

We've known for a decade that the disease is caused by the human immunodeficiency virus (HIV), which weakens the body's ability to fight a group of infections that eventually lead to death. We also know that, unlike many other diseases, this one is completely preventable.

HIV is spread through body fluids, including blood, semen and vaginal secretions. Needle-sharing by drug abusers and unprotected sex are two of the most common means of transmission. My colleagues at the Johns Hopkins School of Public Health confirm that men and women may acquire HIV through sexual contact, and that women are beginning to realize they must take a more aggressive role in protecting themselves.

Q: To what extent are women at risk for HIV and AIDS?

A: More than one-third of AIDS cases in American women are from heterosexual sex, either with an HIV-infected partner or with an IV drug abuser. Most people infected with HIV look and act healthy, and do not know they are carrying HIV. Genital infections such as herpes and syphilis increase the risk of infection because sores allow infected fluids to enter the body.

Q: Are there signs and conditions associated with HIV and AIDS that are specific to women?

A: There are certain conditions that are seen only in women, and they may be indicators of the disease. For example, frequent yeast infections can be a sign of HIV's progression because the immune system is damaged. And if a women is at risk for cervical cancer, she may get it earlier if she has HIV. That's because the human papilloma virus (a sexually transmitted disease that may lead to cervical cancer) seems to spread more quickly when the immune system is depressed.

Q: What has been the response of the medical community?

A: Many doctors are suggesting that pap smears be given more often to women who are HIV positive. In addition, many women with evidence of human papilloma virus by pap smear should be offered HIV testing.

Q: Is it true that women don't get anti-HIV therapies as much as men do?

A: Unfortunately, it appears that women have less access to anti-HIV drugs like AZT and DDI. Women with HIV seem to have less access tocomprehensive medical care than men, which is true in other areas of medical care as well.

Q: Since a large percentage of women get HIV from heterosexual partners, how can they protect themselves?

A: Women who are sexually active with any partner whom they do not know to be HIV negative need to be assertive in insisting on safer sex. Latex condoms made in the United States are one option, but they must be worn through the entire sexual contact. U.S. Food and Drug Administration approval of a female condom is pending, but many women aren't prepared to accept the device, which fits into the vagina and covers the surrounding genital area. Many women ask about vaginal sponges containing a chemical called Nonoxynol-9, but studies show they do not provide protection when used without a condom.

Q: Where can women get condoms if they can't afford them?

A: The Maryland Department of Health and Mental Hygiene provides 3 million free condoms annually to all local health departments, clinics, health services at community colleges and the University of Maryland. Sexually transmitted disease clinics also have them, and you do not have to register or give your name to receive them.

Q: Are they of the same quality as what you can buy?

A: Absolutely. They are latex, made in the United States and do notcontain oil-based lubrication.

It often is difficult to negotiate the use of condoms with sexual partners. But women have the right and obligation to protect themselves with safer behaviors and accurate information. The good news is that not a single man or women needs to get HIV and AIDS. It is an epidemic that is completely preventable.

Dr. Matanoski is a physician and professor of epidemiology at the Johns Hopkins School of Public Health.

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