HIV – AIDS 

 

 

 

Multiple Community Partners Collaborate to Address

HIV/AIDS Among Women in the Pacific Northwest

 

Next month I will have the honor of speaking to a regional training conference about women and HIV/AIDS for health professionals from the Pacific Northwest. This training is just one of many important local, state, and regional community mobilizations aligned with the National HIV/AIDS Strategy that are unfolding across the country.

Like many of those mobilizations, the Friday, April 15, conference in Seattle, HIV/AIDS Conference for Health Professionals: The Feminization of an Epidemic , addresses several of the Strategy’s important priorities.

In this case, those are:

• Engaging all parts of society to address HIV/AIDS – Multiple sectors of the community have come together to organize this training event, including the faith community, health care providers, community-based organizations, and advocates. Sponsors of the event include African American Reach and Teach Health , a faith-based capacity building nonprofit organization established to respond to HIV/AIDS and other major health issues affecting people of African descent, and the Northwest AIDS Education and Training Center , supported by HRSA’s Ryan White program. They are joined by Portland’s Cascade AIDS Project ; Seattle’s Babes Network , a peer support program for women living with HIV of the local YWCA; and the Seattle HIV Vaccine Trials Unit .

• Taking deliberate steps to increase the number and diversity of available providers of clinical care and related services for people living with HIV – Increasing the number of HIV providers, as well as increasing knowledge among all health professionals about HIV risks and prevention is critical to achieving the Strategy’s goals. This involves a wide range of health professionals in all health care settings so that providers who are not HIV specialists are adequately equipped to provide prevention services to high-risk populations and link patients who test positive to HIV clinical care providers. This includes not just physicians, registered nurses, nurse practitioners, and physician assistants, but also social workers, pharmacists, dentists as well as health educators, mental/behavioral health professionals, public health personnel, and substance abuse professionals, all of whom are invited to participate in this training event.

• Reducing HIV-related health disparities and intensifying HIV prevention efforts in communities where HIV is most heavily concentrated – Women have been affected by HIV/AIDS since the beginning of the epidemic, but that impact has grown significantly over time. CDC estimates that 280,000 U.S. women are living with HIV/AIDS today. Women and men have different biological, psychological, and cultural factors that increase their vulnerability to infection and disease progression, so it is important for health care providers to understand these gender differences. Women of color, particularly Black women, have been especially hard hit and represent the majority of new HIV infections and AIDS diagnoses among women, and the majority of women living with the disease in the United States. Given the extreme disparities in infection rates among Black women and Latinas when compared to White women, it is also important to consider the unique factors that place them at higher risk for infection. This disproportionate impact on women of color also underscores the need for health care services that are respectful of and responsive to the health beliefs, practices and cultural and linguistic needs of diverse patients. Such services can greatly help bring about positive health outcomes.

• Reducing stigma and discrimination against people living with HIV – The conference organizers have thoughtfully placed this often challenging topic on the agenda. It is only through such conversations that we will make progress toward eliminating the stigma associated with HIV and the attendant fear of discrimination that causes some Americans to avoid learning their HIV status, disclosing their status, or accessing medical care.

The collaborative efforts of these diverse community partners from across the Northwest, including each of the individual health care providers participating, are making important contributions to the work underway across the country to realize the Strategy’s life-saving goals. I look forward to learning more about their efforts and to sharing with them perspectives on HIV and gender as well as information about the National HIV/AIDS Strategy and PACHA’s efforts to support and monitor its implementation.

By Christopher Bates, M.P.A., Executive Director, Presidential Advisory Council on HIV/AIDS and Senior Advisor to the Deputy Assistant Secretary for Health, Infectious Diseases, U.S. Department of Health and Human Services

 

STATISTIC REPORT on Women having Sex with Women.

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STATISTICS

The following information comes from CDC unpublished data.

• Through December 2004, a total of 246,461 women were reported as HIV infected. Of these, 7,381 were reported to have had sex with women; however, most had other risk factors (such as injection drug use, sex with men who are infected or who have risk factors for infection, or, more rarely, receipt of blood or blood products).
• Of the 534 (of 7,381) women who were reported to have had sex only with women, 91% also had another risk factor—typically, injection drug use.
• HIV-infected women whose only initially reported risk factor is sex with women are given high priority for follow-up investigation. As of December 2004, none of these investigations had confirmed female-to-female HIV transmission, either because other risk factors were later identified or because some women declined to be interviewed.
• A study of more than 1 million female blood donors found no HIV-infected women whose only risk factor was sex with women. Despite the absence of confirmed cases of female-to-female transmission of HIV, the findings do not negate the possibility. Information on whether a woman had sex with women is missing in more than 60% of the 246,461 case reports―possibly because the physician did not ask or the woman did not volunteer the information.

RISK FACTORS AND BARRIERS TO PREVENTION

Surveys of behavioral risk factors have been conducted in groups of women who have sex with women (WSW). These surveys generally have been of WSW samples that differ in criteria for participation, location for recruitment, and definition of WSW. As a result, the findings of these surveys cannot be generalized to all WSW. The findings have, however, suggested that some WSW have other behavioral risk factors, such as injection drug use and unprotected vaginal sex with men who have sex with men (MSM) or men who inject drugs.

PREVENTION

Although there are no confirmed cases of female-to-female transmission of HIV, female sexual contact should be considered a possible means of transmission among WSW. These women need to know

• their own and their partner’s HIV serostatus. This knowledge can help women who are not infected to change their behaviors and thus reduce their risk of becoming infected. For women who are infected, this knowledge can help them get early treatment and avoid infecting others.
• the risk for exposure through a mucous membrane. Potentially, HIV can be transmitted through the exposure of a mucous membrane (in the mouth, for example), especially if the tissue is cut or torn, to vaginal secretions and menstrual blood. The potential for transmission is greater during early and late-stage HIV infection, when the amount of virus in the blood is expected to be highest.
• the potential benefits of using condoms. Condoms should be used consistently and correctly during every sexual contact with men or when using sex toys. Sex toys should not be shared. No barrier methods for use during oral sex have been evaluated as effective by the Food and Drug Administration. However, natural rubber latex sheets, dental dams, condoms that have been cut and spread open, or plastic wrap may offer some protection from contact with body fluids during oral sex and thus may reduce the possibility of HIV transmission.

Health care providers need to remember that sexual identity does not necessarily predict behavior and that some women who identify themselves as WSW or lesbian may be at risk for HIV infection through unprotected sex with men.

REFERENCE

1. CDC. HIV and AIDS: Are You at Risk?



To learn more about the upcoming HIV/AIDS Conference for Health Professionals: The Feminization of an Epidemic, please watch this announcement:

 

A Celebration of Women