What do women need to know?

• Women are at risk for HIV infection. Many women think AIDS is a disease of gay men. But women get HIV from sharing needles and from heterosexual sex.
• During sex, HIV is transmitted from men to women much more easily than from women to men. A woman's risk of infection is higher with anal intercourse, or if she has a vaginal disease. The risk of infection is higher if your sex partner is or was an injection drug user, has other sex partners, has had sex with infected people, or has sex with men.
• Women should protect themselves against HIV infection. Having male sex partners use a condom every time can lower the chance of HIV infection. There is a female condom that provides some protection, but not as much as a male condom. Other forms of birth control, such as birth control pills, diaphragms, or implants do NOT provide protection against HIV. There is not yet any cream or gel (microbicide) that women can use to prevent HIV infection. However, many scientists are working to develop one.
• Get tested if you think you were exposed to HIV. Many women don't find out they have HIV until they become ill or get tested during pregnancy. If women don't get tested for HIV, they seem to get sick and die faster than men. But if they get tested and treated, they live as long as men.
• Viral loads are lower in women. Women tend to have lower viral loads during the first few years of HIV infection. Treatment guidelines suggest considering this for recently infected women with CD4 cell counts over 350. However, HIV disease proceeds at the same rate as for men.
• Gynecological problems can be early signs of HIV infection. Ulcers in the vagina, persistent yeast infections, and severe pelvic inflammatory disease (PID) can be signs of HIV. Hormone changes, birth control pills, or antibiotics can also cause these vaginal problems. See your doctor to make sure you know the cause.
• Women get more and different side effects than men. Women are more likely to get skin rashes and liver problems, and to experience body shape changes (lipodystrophy) than men. They also have more problems caused by human papillomavirus (HPV) HPV problems do not seem to improve when people take antiretroviral therapy (ART).
• Many women are full-time parents in addition to dealing with their health and employment. This can make it more difficult to take medications and schedule medical appointments. With proper support, however, women do very well on HIV treatment.

• Women get vaginal infections, genital ulcers, pelvic inflammatory disease, and genital warts more often and more severely than uninfected women.
• Only 1 woman gets Kaposi's sarcoma, a skin cancer , for every 8 men who get it.
• Women get thrush (a fungal infection) in their throats and herpes (a virus that causes cold sores and genital herpes) about 30% more often than men.
• Women are much more likely than men to get a severe rash when using nevirapine
• Women with fat redistribution are more likely than men to accumulate fat in the abdomen or breast areas and are less likely to lose fat in the arms or legs.
• Unusual growths related to cervical cancer are more frequent and more severe in women who are HIV-positive.