WOMENAND

HIV/AIDS

KEY FACTSMAY 2001

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Key FactsWomen and HIV/AIDS

May 2001

List of Figures

Figure 1. Distribution of People Living With HIV/AIDS, by GenderFigure 2. Trends in New AIDS Cases by Gender, 1993–1999Figure 3. Women as a Proportion of New AIDS Cases, 1986–1999Figure 4. New AIDS Cases and Estimated Population Among Women by

Race/Ethnicity, 1999Figure 5. Trends in Estimated AIDS Deaths by Gender, 1993–1998Figure 6. HIV as a Cause of Death for Women by Age and Race/Ethnicity,

1998Figure 7. Annual AIDS Case Rates Among Women by Race/Ethnicity, 1999Figure 8. Annual AIDS Case Rates Among Women, 1999Figure 9. Top 10 States/Territories for Number of Female AIDS Cases, 1999Figure 10. Annual AIDS Case Rates Among Women by Region and

Race/Ethnicity, 1999Figure 11. Estimated AIDS Cases by Gender and Exposure Category, 1998Figure 12. Percent of Estimated AIDS Cases Among Women, by Race/Ethnicity

and Exposure Category, 1998Figure 13. New AIDS Cases Among Women, by Age, 1999Figure 14. Young Women as a Proportion of AIDS Cases Among All Young

People, 1993 and 1999Figure 15. Estimated AIDS Cases among Young Women by Exposure Category,

1998Figure 16. Selected Characteristics of Persons with HIV/AIDS in Care by

Gender, 1996Figure 17. Insurance Coverage of Persons with HIV/AIDS in Care by Gender,

1996Figure 18. Health Services Use Among Persons with HIV/AIDS in Care by

Gender, 1996Figure 19. Reasons for Postponing Care Among Persons with HIV/AIDS by

Gender, 1996Figure 20. Women’s Communication with Health Care Providers about

HIV/AIDS, 2000Figure 21. Women’s Perceptions of HIV Testing, 1999Figure 22. Women’s Experiences with HIV Testing and Counseling, 1999Figure 23. Women’s Perception of AIDS as an Urgent Problem by

Race/Ethnicity, 2000Figure 24. Women’s Personal Concerns about Becoming Infected with HIV by

Race/Ethnicity, 2000

Introduction

In 1986, in the earlier days of the HIV/AIDS epidemic in this country, women onlyrepresented 7% of new cases of AIDS. By 1999 that share had risen to nearly onequarter. Not only do women represent an increasing share of persons with AIDS, themost advanced stage of HIV infection, they also account for a rising share of individualsinfected with HIV—today representing 30 percent of new HIV infections. Women ofcolor, particularly African American women, have been hardest hit among women.African American women and Latinas account for four in five new cases of HIV. Whilenew treatments can extend the years and quality of life of people with HIV/AIDS, thereis some evidence that women do not have the same access to these life savingtreatments as men and are faring more poorly.

This report Key Facts: Women and HIV/AIDS provides an overview of the impact of theHIV/AIDS epidemic on women. It draws from recent data and research on theepidemiology of HIV/AIDS among women, including data on cases and mortality; healthservices use and coverage; and attitudinal data from several recent national surveys.Key Facts presents current snapshots as well as trends over time and examines theimpact of the epidemic on women generally, as well as the disproportionate impact onminority women.

Section One provides an overview of women and the HIV/AIDS epidemic. Section Twohighlights demographic characteristics of women with HIV/AIDS, including data onregional and state variations, age and other risk factors for women. Section Threeprovides an overview of women with HIV/AIDS and the health care system, and finally,Section Four highlights recent findings on women’s attitudes towards HIV/AIDS.

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Section I

Overview

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Section II

Women at Risk

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Section III

Women with HIV/AIDS and the Health Care System

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Section IV

Women’s Attitudes TowardHIV/AIDS

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Conclusion

Today, some of the news about the HIV/AIDS epidemic in this country is morepositive—death rates are down and many people infected with HIV are living lives thatare healthier and more productive than were imaginable even a decade ago. However,many others are falling through the cracks. The stories and experiences of HIV-infectedwomen have been largely overlooked. Despite advances in the prevention andtreatment of HIV, women continue to be affected by the epidemic and do not appear tohave benefited from advances to the same degree as men. Of particular concern is thegrowing impact of the epidemic on minority—particularly African American—and youngwomen. Minority women already represent the majority of newly reported AIDS casesamong women and teen girls represent the majority of AIDS cases in their age group.Targeted public education and prevention efforts focused on minority women and youngwomen should be a priority to stem the spread of HIV.

A growing body of research has demonstrated that HIV-infected women fare morepoorly on several measures of access to and quality of health care. Women withHIV/AIDS tend to be more socially and economically disadvantaged than their malecounterparts. They are disproportionately low-income and poorly educated, factorsalone associated with poorer access to health care. Compared to men with HIV, womenin care have less access to the state of the art treatments and therapies that canprolong and improve their lives. Research shows that a significant share of HIVpositive individuals is not receiving any care and does not know their HIV status.Furthermore, among women who do have access to health care services, surveyresearch finds that many are not receiving the HIV counseling or testing they need tobe identified and directed to treatment. Additional attention to counseling and earlytesting, improved access to treatment, and expansions in the availability of enhancedservices for women and their families is warranted.

To date, there has been little focus on the effect of the HIV/AIDS epidemic on women.Given the impact of the disease on women, particularly those who are the mostvulnerable, efforts to improve and expand opportunities for prevention and treatmentshould be broadened. The apparent gender disparities in access to care and concernsabout quality highlight the importance of further research and policy attention on HIVand its effect on women.

This document was prepared by Zena Itani of the University of Michigan, while she was anintern at the Kaiser Family Foundation, and Jennifer Kates, Senior Program Officer, HIV/AIDSPolicy, of the Kaiser Family Foundation.

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Tables

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Sources

Bozzette, et al. (1998). “The Care of HIV-Infected Adults in the United States” NewEngland Journal of Medicine, Vol. 339, No. 26.

Centers for Disease Control and Prevention, AIDS Weekly Surveillance Report—UnitedStates, December 1986.

Centers for Disease Control and Prevention, HIV/AIDS Surveillance Report, Year-EndEdition, 1990.

Centers for Disease Control and Prevention, HIV/AIDS Surveillance Report, Year-EndEdition, Vol. 5, No. 4, 1993.

Centers for Disease Control and Prevention, HIV/AIDS Surveillance Report, Year-EndEdition, Vol. 6, No. 2, 1994.

Centers for Disease Control and Prevention, HIV/AIDS Surveillance Report, Year-EndEdition, Vol. 7, No. 2, 1995.

Centers for Disease Control and Prevention, HIV/AIDS Surveillance Report, Year-EndEdition, Vol. 8, No. 2, 1996.

Centers for Disease Control and Prevention, HIV/AIDS Surveillance Report, Year-EndEdition, Vol. 9, No. 2, 1997.

Centers for Disease Control and Prevention, HIV/AIDS Surveillance Report, Year-EndEdition, Vol. 10, No. 2, 1998.

Centers for Disease Control and Prevention, HIV/AIDS Surveillance Report, Year-EndEdition, Vol. 11, No.2, 1999.

Centers for Disease Control and Prevention, HIV/AIDS Surveillance in Women, L264Slide Series, 1999.

Centers for Disease Control and Prevention, National Center for Health Statistics,National Vital Statistics System, National Vital Statistics Reports, Deaths: Final Datafor 1998, Vol. 48, No. 11.

Cunningham, et al. (1999). “The Impact of Competing Subsistence Needs and Barrierson Access to Medical Care for Persons with Human Immunodeficiency VirusReceiving Care in the United States.” Medical Care, Vol. 37, No. 12.

Kaiser Family Foundation, National Survey of Americans on HIV/AIDS 2000, conductedAugust 14–October 26, 2000.

Kaiser Family Foundation/Essence/Latina/LA Times, National Survey of Women’sReproductive Health Care, conducted January 6–January 21, 1999.

Personal Communication, Pat Sweeney, Centers for Disease Control and Prevention,Division of HIV/AIDS Prevention, July 2000.

Shapiro, et al. (1999). “Variations in the Care of HIV-Infected Adults in the UnitedStates.” Journal of the American Medical Association, Vol. 281, No. 24.

Urban Institute. Estimates based on the March 2000 Current Population Survey, U.S.Bureau of the Census, for the Kaiser Family Foundation.

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