The epidemic of human immunodeficiency virus infection is growing more rapidly in women than in men in almost every part of the world, according to a new report.
The feminization of AIDS appears to reflect a maturing of the epidemic, suggest the authors of the annual AIDS update prepared by the United Nations, World Health Organization and World Bank. More and more seemingly low-risk women, many of them married, are being infected by men who acquired the virus through high-risk behavior years ago.
The trend is most advanced in sub-Saharan Africa, where the AIDS epidemic began and home to more than half the world?s HIV-infected people. Women there now comprise 57 percent of people living with the virus.
From 2002 to 2004, the percentage of infected people who are women rose or stayed the same in all regions.
The evolving risk to women is a main theme in the report that paints a mosaic portrait of the global AIDS epidemic.
The growing proportion of infected women reflects the cumulative effect of many risks. They include the fact that women, especially teenage girls, are more physiologically vulnerable than men; the inability of many women to require their partners to use condoms; the infidelity of husbands and the high-risk behavior of other male partners; the exploitation of young women by older men, especially in southern Africa; and rape and other forms of sexual coercion.
In South Africa, Zambia and Zimbabwe, women ages 15 to 24 are three to six times more likely to become infected than young men. In the Caribbean, young women?s risk is twice that of men.
Marriage is no protection against infection – and in some places appears to increase the risk.
In India, where about 5.1 million people are infected, women account for one-quarter of new infections. Among those who test positive at prenatal clinics, 90 percent say they are in monogamous, long-term relationships. In a study of young women in Kisumu, Kenya, and in Ndola, Zambia, married teenage girls were more likely to be infected than unmarried, sexually active ones.
Black women now account for 72 percent of infections in women in the United States. A recent study of a low-income section of New York found that women were twice as likely to be infected by a husband or long-term lover as by a casual sex partner.
In some places, however, women?s plight is improving, according to the report , which draws on national reports and dozens of epidemiological surveys.
For example, the percentage of women at prenatal clinics in Uganda and Kenya who were infected fell from 13 percent in 1998 to about 9 percent in 2002. At clinics in Ethiopia, it fell from 14 percent to 12 percent.