HIV: What Women Need to Know

By

Beth Orenstein

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PHYSICIAN CONTRIBUTOR

Finding the Right HIV 'Cocktail'

There’s no “one size fits all” when it comes to choosing an HIV treatment regimen.
portrait-of-woman

At the start of the HIV/AIDS epidemic, most people who were HIV positive were gay men. Today, about half of those worldwide who are living with HIV are women. Most women get HIV from having unprotected sex with men. In some respects, living with HIV is different for women than men. Women have a different role in society than men, as well as unique health concerns when faced with HIV.

Women in Society

Women tend to be caregivers, with more family responsibilities. They often put children and partners first, making it difficult to schedule doctor appointments and find time to get the support they need to manage HIV effectively. Many women have lower incomes than their male counterparts, fewer resources, and less access to affordable healthcare than men with HIV.

Anti-HIV Drug Side Effects Differ

Powerful anti-HIV medications can work well in women and men, but can have different side effects. Women who take ritonavir (Norvir, RTV) seem to have more nausea and vomiting, but less frequent diarrhea than men on this drug. Women also seem to be more susceptible to rashes, weight gain in their breasts and at their waist, and problems with their pancreas and liver than men on the same anti-HIV drugs. Doctors advise women not to start a drug combination with nevirapine (Viramune), because it could put them at risk for dangerous liver problems.

Health Risks Differ

All women are at risk for bone thinning (osteoporosis), especially after menopause. But living with HIV raises that risk considerably, no matter what your age. And your chance of developing osteoporosis is three times greater than that of men with HIV.

HIV-positive women also are more likely than men to:

  • Develop bacterial pneumonia

  • Contract herpes

  • Get thrush (a yeast infection) in their throats

However, women are much less likely than men to develop Kaposi’s sarcoma. This is a lethal skin cancer diagnosed more frequently in individuals with AIDS.

Gynecologic Problems Are More Likely

Because of female hormones, women with HIV are more susceptible to gynecologic problems than are women without HIV. These include:  

  • Vaginal yeast infections. HIV makes them more persistent and difficult to treat.

  • Other vaginal infections. Women with HIV often get bacterial vaginosis and common sexually transmitted diseases, such as gonorrhea, chlamydia, and trichomoniasis.  

  • Human papillomavirus (HPV). Women with HIV have a greater chance of being infected with HPV than HIV-negative women. Specific strains of this virus increase a woman’s chances of developing cervical cancer.

  • Pelvic inflammatory disease (PID). Anti-HIV drugs weaken your immune system, which puts you at greater risk of PID.

  • Menstrual period irregularities. You may experience heavy bleeding or your periods may stop.

HIV and Pregnancy

If you’re HIV positive and want to become pregnant, you’ll have to talk to your doctor about steps to take to deliver a healthy baby. Specific drugs can significantly lower your chance of passing HIV to your baby—from 25% to less than 2%. However, some anti-HIV drugs can cause birth defects and you should avoid them during pregnancy.

Above all, Ob-Gyn visits are an important part of your overall health plan when you’re a woman with HIV. Remember to schedule regular gynecologic exams, including Pap smears. Pap smears detect cervical cancer and abnormal cells known to develop into cancer.

Key Takeaways

  • Women living with HIV face different challenges than men, including more HIV drug side effects. Talk to your doctor if you are having trouble coping.

  • HIV treatments work just as well for women as for men, so be sure to continue your treatment plan.

  • Having HIV makes you more susceptible to women’s issues, such as vaginal infections and other conditions.

  • If you want to become pregnant, family planning with the help of your doctor is essential to safeguard your baby.

  • Make regular Ob-Gyn visits part of your overall health plan, to minimize the gynecologic consequences of HIV.

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Medical Reviewers: William C. Lloyd III, MD, FACS Last Review Date: Aug 10, 2015

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View Sources

Medical References

  1. What’s so different for women? Positive Women’s Network. http://pwn.bc.ca/hiv-community/whats-so-different-for-women/
  2. HIV and AIDS--Medicines to Help You. U.S. Food and Drug Administration. http://www.fda.gov/forconsumers/byaudience/forwomen/ucm118597.htm
  3. Women and HIV. The Well Project. http://www.thewellproject.org/hiv-information/women-and-hiv
  4. How does HIV and AIDS affect girls and women? UNICEF. http://www.unicef.org/aids/index_hivaids_girls_women.html
  5. HIV/AIDS drugs and side effects. Office on Women's Health, U.S. Department of Health and Human Services. http://www.womenshealth.gov/hiv-aids/treatments-for-hiv-aids/hiv-aids-drugs-and-side-effects.html

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