HIV Infection in Women

What are HIV and AIDS?
Human immunodeficiency virus (HIV) is a virus that destroys the immune system. HIV targets CD4 cells, or helperT cells, which are cells in your blood that help the body fight disease. Over many years, the CD4 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 as a result of the loss of CD4 cells, the person is said to have "acquired immunodeficiency syndrome" (AIDS).

How do women become infected with HIV?
HIV is spread through contact with blood, semen or other body fluids (except saliva) from a person infected with HIV. This can happen during sex. It can also happen when needles are shared with a person infected with HIV. 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 donated blood that contained HIV. These days, HIV infection is much more widespread. Here is a list of people
who are at high risk of HIV infection:

• Men who have sex with other men.
• Anyone who has multiple sex partners.
• Anyone who has sex with a prostitute.
• Anyone who shares needles using illegal injected drugs.
• Anyone who exchanges sex for drugs or money.
• Anyone who has a sexually transmitted disease.
• Anyone who has had or currently has a sexual partner with any of the aboverisk factors.
  

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 other body fluids 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, such as Pneumocystis pneumonia or Kaposi's sarcoma, 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 helps prevent HIV infection. 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 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. Birth control pills, Injections of medroxyprogesterone acetate and contraceptive implants do not protect a woman from getting HIV infection. They only protect her from getting pregnant.

How do babies get HIV from their mothers?
Babies can get HIV infection from their mothers during pregnancy, during the birth process and during breastfeeding. 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. (AAFP)