Dr. MJ Bazos MD, Patient Handout
HIV Infection in Women

What are HIV and AIDS?

HIV (human immunodeficiency virus) is a virus that destroys the immune system. The virus affects certain white blood cells, called T4 helper cells, which help the body fight disease. Over many years, the white blood cells are destroyed. The body then has a weaker defense against infections such as lung infections, mouth infections and eye infections. Some forms of cancer, such as lymphoma or cervical cancer, may also occur. When infections and other problems occur, the person is said to have AIDS (acquired immunodeficiency syndrome).

How do women become infected with HIV?

HIV is spread through contact with blood or semen of a person infected with HIV. This can happen during sex. It can also happen when needles are shared with a person infected with HIV. People who inject drugs might get HIV if they share a needle with an infected person. In the past, HIV was also spread through blood transfusion. Blood donations are now tested for HIV, and HIV-infected blood is destroyed. HIV is not spread by casual contact such as hugging, kissing, holding hands, sitting on toilet seats or sharing clothing.
More than half of women who have HIV got the infection from sexual partners. A woman can be infected by contact with a man or contact with another woman. When a woman has sex with an infected man, she has a high risk of getting HIV if a condom is not used properly. Ask your doctor for instructions on proper use of condoms.

Who is at risk for HIV infection?

In the early days of the AIDS epidemic, HIV infection appeared to be confined to certain groups, including intravenous drug users, men who have sex with other men and persons with hemophilia (a blood-clotting disease that requires treatment with frequent blood transfusions). People with hemophilia got HIV from receiving blood transfusions with blood that contained HIV. Getting HIV from blood transfusions is no longer a problem because there now are tests to screen blood for HIV infection.
These days, HIV infection is much more widespread. Here is a list of people who are at high risk of HIV infection:
Since most people who are infected with HIV appear healthy, a blood test for the virus is necessary to see who has the infection. People who have a positive blood test for HIV are called HIV-positive. Ask your doctor how to obtain confidential testing for HIV. Your doctor can help you understand what the test results mean.
The only 100% sure way to keep from getting the AIDS virus is to not have sex at all or to have sex only with a partner who does not have HIV infection. Avoiding contact with human blood and not sharing needles are also important steps in avoiding HIV infection.

Is HIV infection different in women and men?

HIV infection is somewhat similar in men and women. For a long time after becoming infected, the person seems healthy. Over many years, the person's immune system gradually becomes weaker until it is unable to fight off other infections. In general, the types of infections that people with HIV get and their treatments are the same in women and men.
The difference between men and women is that HIV-infected women often have additional problems such as repeated vaginal yeast infections, especially as the immune system becomes weaker. More serious infections, such as PID (pelvic inflammatory disease--an infection of a woman's internal reproductive organs), can be harder to treat because the body can't help in fighting off infections as well. Diseases of the cervix, such as precancer (dysplasia) and cancer, progress faster. They can be harder to treat if a woman has HIV.

What precautions can be taken to avoid getting HIV during sex?

A male latex condom that is used properly is a way to help prevent HIV and other sexually transmitted diseases. It also helps to prevent a woman from giving HIV infection to her sexual partner. The male latex condom also helps to protect a woman from other sexually transmitted diseases, such as herpes, gonorrhea, genital warts and syphilis.
The female condom (brand name: Reality) also helps block the spread of HIV. Doctors suggest using a female condom when a male condom can't be used. The diaphragm may not provide protection against HIV. Injections of medroxyprogesterone acetate (brand name: Depo-Provera) and contraceptive implants (brand name: Norplant) do not protect a woman from getting HIV infection. They only protect her from getting pregnant. Birth control pills also do not protect against HIV infection.
How do babies get HIV from their mothers?
Babies can get HIV infection from their mothers during pregnancy, during the birth process and during breast-feeding.
It is now possible to prevent many cases of HIV in children by giving medicines to the pregnant mother and to her newborn baby. This protection cannot be offered if a pregnant woman does not know she is infected. Many people with HIV feel perfectly healthy at first. The only way to know if you are infected is to have an HIV test. If you are pregnant, ask your doctor for an HIV test as part of your prenatal care. Better yet, if you are thinking about getting pregnant, talk to your doctor about HIV tests for you and your partner.

What should I do if I think I may be infected?

If you think you may be infected with HIV, contact your doctor immediately. Even though there is no cure for the disease, early diagnosis and treatment with medicines can be started to slow the progression of the disease. Your doctor will be able to give you more advice about how to take care of yourself if tests show that you have HIV.