Centers for Disease Control and Prevention
February 9, 1995

Facts about. . .

Women and HIV/AIDS

Through December 1994, the Centers for Disease Control and Prevention (CDC) received reports of 58,428 cases of acquired immunodeficiency syndrome (AIDS) among adult and adolescent (13 years and older) women in the United States. The proportion of women among cases in adults and adolescents has increased steadily, from 7 percent in 1985 to 18 percent in 1994.

The 14,081 women reported with AIDS in 1994 represented nearly one-fourth (24 percent) of the total number of AIDS cases ever reported among women. Forty-one percent of women reported with AIDS in 1994 acquired human immunodeficiency virus (HIV) through injection drug use and 38 percent through heterosexual contact with at-risk partners. The remaining 21 percent of these women received contaminated blood or blood products (2 percent) or had no specific exposure reported (19 percent).

Of the 5,353 women reported with AIDS in 1994 whose HIV infections were attributed to heterosexual contact, 38 percent reported sexual contact with a male injection drug user and 53 percent with a partner with HIV/AIDS whose risk was not specified. The large proportion of women reported with AIDS in 1994 with unreported risk will decrease after investigation by local/state health departments. After follow-up, most women are found to have a recognized risk for HIV infection. Heterosexual contact with an HIV-infected man is the most rapidly increasing transmission category among women.

AIDS and other illnesses due to HIV infection have been the fourth leading cause of death since 1992 among U.S. women aged 25 to 44. In this age group, the rank of HIV infection among causes of death for black women advanced from second in 1992 to first in 1993, and for white women, from sixth in 1992 to fifth in 1993. (Data for 1993 are provisional.)

Although black and Hispanic women make up 21 percent of all U.S. women, more than three-fourths (77 percent) of AIDS cases reported among women in 1994 occurred among blacks and Hispanics. For adult and adolescent U.S. women, the AIDS case rate per 100,000 population in 1994 was 3.8 for non-Hispanic whites; 62.7 for non-Hispanic blacks; 26.0 for Hispanics; 1.3 for Asian/Pacific Islanders; and 5.8 for American Indians/Alaska Natives. The AIDS rate for black and Hispanic U.S. women was approximately 16 and 7 times greater, respectively, than that for white U.S. women.

Data from the HIV Survey in Childbearing Women indicated that in 1993 an estimated 7,000 HIV-infected women delivered infants in the United States. Assuming a perinatal HIV transmission rate of 15 percent to 30 percent, approximately 1,000-2,000 infected infants were born during 1993.

CDC's Prevention Activities.

CDC provides prevention messages to women through community-based organizations (CBOs), school-based programs, and public information and education programs. Through health departments and CBOs, women at risk for HIV are reached with interventions such as street outreach, risk-reduction counseling, and prevention case management. CDC~s programs include a number of activities designed to educate women, and the public in general, about how HIV is transmitted, who is at risk of acquiring the infection, and how the infection can be prevented. These activities include a national media educational campaign, the CDC National AIDS Hotline, and the CDC National AIDS Clearinghouse. (See telephone numbers, page 3.)

In collaboration with the National Institutes of Health (NIH), CDC initiated the HIV Epidemiology Research Study at four U.S. sites to investigate the natural history of HIV disease in women and to characterize risk factors for conditions indicative of AIDS in women. CDC also awarded funds to an additional four sites to develop, implement, and evaluate programs for the prevention of HIV infection and AIDS among women and infants.

Also in collaboration with NIH, CDC is evaluating the effectiveness of the female condom and assessing the determinants of its consistent and correct use.

Several ongoing HIV evaluation studies are specifically directed to women and are designed to:

  • Evaluate occurrence and response to treatment of several gynecological conditions, such as cervical dysplasia, pelvic inflammatory disease, vaginal candidiasis, sexually transmitted diseases, and menstrual disorders;
  • Define rates and risk factors for mother-to-infant HIV transmission;
  • Evaluate behavioral issues, such as occurrence and determinants of mental illness (e.g., stress, depression) and methods of coping with life problems;
  • Evaluate the relationship between various behaviors, including cocaine and other drug use, and sexually transmitted diseases in adolescent women;
  • Evaluate the effectiveness of a variety of interventions on increasing contraceptive use among women who do not wish to become pregnant and are at high risk for HIV infection or are HIV infected;
  • Develop, implement, and evaluate community interventions to prevent further transmission of HIV in a community; of seven community demonstration projects, five are focused on women~s issues.
  • Develop, implement, and evaluate new interventions to reach women with or at high risk for HIV infection.

Recent CDC Initiatives

Women are among the population groups expected to benefit from two CDC initiatives that began in early 1994:

The "HIV Prevention Community Planning Initiative" represents a significant step forward in the planning of culturally competent and scientifically sound HIV prevention services that specifically address unique community needs. Community planning is a process whereby the identification of high priority prevention needs is shared between the health department administering HIV prevention funds and representatives of the communities for whom the services are intended. In addition, the community planning process embraces the notion that the behavioral and social sciences must play a critical role in the development, implementation, and evaluation of HIV prevention programs within a community.

The Prevention Marketing Initiative (PMI). CDC's PMI is a large-scale national effort to change behaviors that contribute to the transmission of HIV and other sexually transmitted diseases (STDs). It represents a shift from previous mass health communications programs, aimed at increasing general awareness of HIV/AIDS, to influence behavior changes among people at high risk for HIV infection or transmission. PMI is an application of marketing techniques and consumer-oriented communications technologies based on science and directed, in its first phase, to the prevention of sexual transmission of HIV and other STDs among young adults 18-25 years of age. To achieve the PMI behavioral objectives, CDC will work simultaneously at the national, state, and local levels through four components: (1) National Communications, (2) Prevention Collaborative Partners, (3) Local Demonstration Sites, and (4) Application in HIV Prevention Community Planning.

For more information:

     CDC National AIDS Hotline     1-800-342-AIDS (2347)
          Spanish:                 1-800-344-SIDA (7432)
          Deaf:                    1-800-243-7889
     CDC National AIDS Clearinghouse
     P.O. Box 6003
     Rockville, Maryland  20849-6003    1-800-458-5231

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