Women and HIV/AIDS

The first case of HIV in a woman was recorded in 1981.[1] Since then, numerous women have been infected with the HIV/AIDS virus. The majority of HIV/AIDS cases in women are directly influenced by high-risk sexual activities, injectional drug use, the spread of medical misinformation, and the lack of adequate reproductive health resources in the United States.[2] Women of color, LGBTQ women, homeless women, women sex workers, and women intravenous drug users are at an extremely high-risk for contracting the HIV/AIDS virus.[3][4][5] In an article published by the Annual Review of Sociology, Celeste Watkins Hayes, an American sociologist, scholar, and professor wrote, "Women are more likely to be forced into survival-focused behaviors such as transactional sex for money, housing, protection, employment, and other basic needs; power-imbalanced relationships with older men; and other partnerings in which they cannot dictate the terms of condom use, monogamy, or HIV."[2][3]

From the start of the HIV/AIDS epidemic in the U.S., women have been excluded and erased from the medical, governmental, and societal institutions that aim to prevent and treat HIV/AIDS.[6] Initially, the medical community in the U.S. deemed lesbian, bisexual and queer women, as well as women who have sex with women (WSW), immune to the HIV/AIDS virus.[4] Although this was later corrected, the spread of such false information had resulted in many women engaging in high risk sexual activities, due to the belief that they were unable to contract the HIV/AIDS virus.[4] Lesbian, bisexual, and queer women who become infected with HIV/AIDS are statistically classified in the U.S. as heterosexual, intravenous drug, or indefinable transmission, despite the fact that it could have been contracted from another women.[4] Lesbian, bisexual, and queer women who are infected with the HIV/AIDS virus through sexual assault by men are also statistically categorized as heterosexual transmission.[4] Women with HIV/AIDS have been excluded from medical studies, clinical trials, financial grants, reproductive health resources, and an adequate HIV education.[3] Women with the HIV/AIDS virus got less attention from medical, governmental, and societal institutions because of the focus on men with the HIV/AIDS virus.[6]

History

Historically, women have often been excluded from HIV and AIDS advocacy, treatment, and research. At the start of the AIDS epidemic in 1981, medical and scientific communities did not recognize women as a group for research. Women were excluded from clinical trials of medication and preventative measures. They were also often blocked from being subjects in clinical research with exclusionary with restrictions like "no pregnant or non-pregnant women".[7] The National Institutes of Health (NIH) rejected grants that were targeted at understanding HIV in low-income women of ethnic minorities.[7] This lack of attention is often attributed to the prominence of the gay rights movement in the area of HIV and AIDS. HIV's clinical symptoms differ between men and women, and the focus on male symptoms caused medical professionals to overlook symptoms in women.

The first case of HIV in a woman in the US was reported in 1981.[1] In December 1982, the first cases of mother-to-child HIV transmission were recorded. The number of children infected with the virus increased throughout the decade. Zidovudine (ZDV), alternatively named azidothymidine (AZT), was introduced as a drug to treat HIV in the late 1980s, reducing the chance of mother-to-child transmission by up to 70%.[8][9]

As of 2019, women account for about 20% of reported HIV cases.[10] The two major modes of transmission to women are heterosexual sexual intercourse and intravenous drug use.[10]

Women can transmit the HIV/AIDS virus to other women through sexual intercourse.[11] However, the U.S. does not statistically categorize HIV/AIDS transmission in forms other than heterosexual, intravenous drug, or indefinable transmission.[4] Due to lack of research, statistics on women-to-women transmission of HIV is unknown.[12] Whether or not a woman had sex with a woman is missing from over 60% from all HIV medical reports in the U.S.[13][4]

Timeline
1982
1983
  • The NIH began to hire female nurses such as Barbara Fabian Baird to research AIDS.[14][16]
  • The Women's AIDS Network was established.[14][17]
  • The CDC added "female sexual partners of males with AIDS" as a risk category.[18][19][20]
1984
  • Social worker Caitlyn Ryan became the first executive director of AID Atlanta, the oldest AIDS service organization in the Southwestern US .[21]
1985
1986
  • Women represented 7% of cases of AIDS in the US.[14][23]
  • The first book about AIDS policy, AIDS: A Public Health Challenge , was co-authored by Caitlyn Ryan. It served as a guide to many public officials.[14][24]
  • Marie St. Cyr became the first director of the New York -based Women and AIDS Resource Network (WARN).[14][25]
1987
  • The NIH allocated 13.5% of its total budget to women's health issues.[14]
  • At the time, women were excluded from HIV trials unless they used birth control. No specifically AIDS- or HIV-related medical assistance or gynecological (relating to the female reproductive system and the breasts) care was provided.[7][14]
  • The Food and Drug Administration (FDA) approved ZDV (AZT) as the first antiretroviral drug to treat AIDS.[23][26]
1988
1990
  • The First National Women and HIV Conference was held in Washington, DC.[8][14]
  • The John H. Stroger Jr. Hospital of Cook County in Chicago, the only hospital in the city with an AIDS ward at the time, refused to admit women. Demonstrators set up a ward in a street in protest, and 35 protestors were arrested. Women were admitted to the ward two days after the protest.[14]
  • The Women's Caucus of the AIDS Coalition to Unleash Power (ACT UP) wrote Women, AIDS, and activism .[8]
  • On May 21, ACT UP members protested for the NIH to include women and people of color in HIV trials and treatment research.[9]
1992
1993
  • The US Congress enacted the NIH Revitalization Act, giving the Office of AIDS Research (OAR) primary oversight of all AIDS research in the NIH. The act required all agencies to include women and ethnic minorities in research.[8][9]
  • Gena Corea's book, The Story of Women and AIDS: The Invisible Epidemic , was published.[14]
  • HIV became the leading cause of death for African-American women aged 25–44.[28]
1994
1996
  • The annual number of new AIDS cases in the US declined because of antiretroviral therapies.[14]
1997
  • Women accounted for more than half of all cases of HIV globally.[14]
  • In the US, 75% of diagnosed HIV cases were in African-American women.[14]
1999
  • 1.1 million women globally died from HIV/AIDS.[29]
  • In America, girls aged 13 years old to 19 years old make up the majority of new HIV/AIDS cases.[30]
2002
  • 2 million women worldwide became infected with HIV/AIDS.[29]
  • 1.2 million women around the world died from HIV/AIDS.[29]
2008
  • Native American women became the third most likely to contract HIV/AIDS, following Black and Latina women.[31]
  • Native American women are found to be 2.4 times as likely to contract HIV/AIDS, compared to white women.[31]
2010
  • Women began representing 1 out of every 4 cases of HIV/AIDS in the U.S.[2]
2011
  • HIV/AIDS became the leading cause of death for African American women aged 25 to 34.[30]
  • Black women are found to be 15 to 20 times as likely to become infected with HIV/AIDS than their white counterparts.[30][32]
  • Latina women are found to be 4 times as likely to contract HIV/AIDS than white women.[32]
2018
  • The CDC determines 14.1% of all transgender women in the U.S. have HIV/AIDS.[33]
  • It is established that 44.2% of all HIV infected transgender women in the U.S. are Black women.[33][34]
  • Research shows that 25.8% of all HIV infected transgender women in the U.S. are Latina women.[33][34]

References
  1. Dean, Hazel D.; Lee, Lisa M.; Thompson, Melanie; Dannemiller, Tracy (November 2004). "Impact of HIV on Women in the United States1". Emerging Infectious Diseases. 10 (11): 2030–2031. doi:10.3201/eid1011.04-062308. ISSN 1080-6040. PMC 3363322. PMID 16010735.
  2. Watkins-Hayes, Celeste (2014-07-30). "Intersectionality and the Sociology of HIV/AIDS: Past, Present, and Future Research Directions". Annual Review of Sociology. 40 (1): 431–457. doi:10.1146/annurev-soc-071312-145621. ISSN 0360-0572.
  3. Pinkham, Sophie; Malinowska-Sempruch, Kasia (2008). "Women, Harm Reduction and HIV". Reproductive Health Matters. 16 (31): 168–181. doi:10.1016/s0968-8080(08)31345-7. ISSN 0968-8080. PMID 18513618. S2CID 41960235.
  4. Logie, Carmen H.; Gibson, Margaret F. (2013). "A mark that is no mark? Queer women and violence in HIV discourse". Culture, Health & Sexuality. 15 (1): 29–43. doi:10.1080/13691058.2012.738430. ISSN 1369-1058. PMID 23140506. S2CID 205797540.
  5. Logan, Jennifer & Frye, Alison & Pursell, Haley & Anderson-Nathe, Michael & Scholl, Juliana & Korthuis, Todd. (2013). "Correlates of HIV Risk Behaviors Among Homeless and Unstably Housed Young Adults. Public health reports". Public Health Reports. 128 (3): 153–160. doi:10.1177/003335491312800305. PMC 3610067. PMID 23633730 – via Pubmed.CS1 maint: multiple names: authors list (link)
  6. "A history of HIV/AIDS in women: Shifting narrative and a structural call to arms". American Psychological Association. Retrieved 2019-04-23.
  7. "A history of HIV/AIDS in women: Shifting narrative and a structural call to arms". American Psychological Association. Retrieved 2019-04-23.
  8. Jul 20, Published; 2018 (2018-07-20). "Global HIV/AIDS Timeline". The Henry J. Kaiser Family Foundation. Retrieved 2019-04-25.CS1 maint: numeric names: authors list (link)
  9. "A Timeline of HIV and AIDS". HIV.gov. U.S. Department of Health and Human Services. 2016-05-11. Retrieved 2019-04-25.
  10. "amfAR :: Statistics: Women and HIV/AIDS :: The Foundation for AIDS Research :: HIV / AIDS Research". www.amfar.org. Retrieved 2019-10-04.
  11. Agénor, Madina (2006). "It's Time We Recognize: Young Women of Color Who Have Sex with Women Are at Risk for HIV Too! Off Our Backs". Off Our Backs. 36: 41–44. JSTOR 20838719 – via JSTOR.
  12. Norman, Ann Duecy; Perry, Melissa J.; Stevenson, L. Yvonne; Kelly, Jeffrey A.; Roffman, Roger A. (1996). "Lesbian and Bisexual Women in Small Cities: At Risk for HIV?". Public Health Reports (1974-). 111 (4): 347–352. ISSN 0033-3549. JSTOR 4598030.
  13. "HIV/AIDS & U.S. Women Who Have Sex With Women (WSW)". PsycEXTRA Dataset. 2003. doi:10.1037/e309122004-001. Retrieved 2020-11-12.
  14. Wilder, From Terri. "A Timeline of Women Living With HIV: Past, Present and Future". TheBody.com. Retrieved 2019-04-25.
  15. "A Report on Women and HIV/AIDS in the U.S." (PDF). Kaiser Family Foundation. April 2013. Retrieved 24 April 2019.
  16. "In Their Own Words". History of the United States National Institutes of Health. Retrieved 2019-04-25.
  17. "Finding Aid to the Women's AIDS Network (WAN) Records, 1985-1992". Online Archive of California. Retrieved 2019-04-25.
  18. "The New York City AIDS Memorial". The New York City AIDS Memorial. Retrieved 2019-04-25.
  19. "History of HIV and AIDS overview". AVERT. 2015-07-20. Retrieved 2019-04-25.
  20. "Epidemiologic Notes and Reports Immunodeficiency among Female Sexual Partners of Males with Acquired Immune Deficiency Syndrome (AIDS) -- New York". U.S. Centers for Disease Control and Prevention. Retrieved 2019-04-26.
  21. Wilder, Terri; M.S.W.June 1; 2012. "A Timeline of Women Living With HIV: Past, Present and Future -- 1984 | TheBody". www.thebody.com. Retrieved 2019-10-04.CS1 maint: numeric names: authors list (link)
  22. "Our History in Pictures". San Francisco AIDS Foundation. Retrieved 2019-04-26.
  23. "The Ryan White HIV/AIDS Program - A Living History". Health Resources and Services Administration (HRSA). U.S. Department of Health and Human Services. Retrieved 2019-04-25.
  24. Robinson, Adjoa. "In Social Work Podcast Series" (PDF). In Social Work. Retrieved 24 April 2019.
  25. Treichler, Paula A. (1999). How to Have Theory in an Epidemic: Cultural Chronicles of AIDS. Duke University Press. ISBN 9780822323181.
  26. "Approval of AZT News". AIDSinfo. Retrieved 2019-04-25.
  27. Maggenti, Maria. Interview with Sarah Schulman and Jim Hubbard. ACTUP Oral History Project. February 16, 2005. MIX: The New York Lesbian & Gay Experimental Film Festival. December 11, 2005, Actupralhistory.org
  28. "Timeline: 30 Years of AIDS in Black America". FRONTLINE. Retrieved 2019-04-25.
  29. Roy, Chandreyee (2005). "Human Rights and HIV/AIDS with Special Reference to Women". Indian Anthropologist. 35 (1/2): 97–110. ISSN 0970-0927. JSTOR 41919981.
  30. Melton, Monica L. (2011). "Sex, Lies, and Stereotypes: HIV Positive Black Women's Perspectives on HIV Stigma and the Need for Public Policy as HIV/AIDS Prevention Intervention". Race, Gender & Class. 18 (1/2): 295–313. ISSN 1082-8354. JSTOR 23884880.
  31. "HIV/AIDS Among American Indians and Alaska Natives". PsycEXTRA Dataset. 2008. doi:10.1037/e537102009-001. Retrieved 2020-11-12.
  32. Aziz, Mariam; Smith, Kimberly Y. (2011). "Challenges and Successes in Linking HIV-Infected Women to Care in the United States". Clinical Infectious Diseases. 52: S231–S237. doi:10.1093/cid/ciq047. ISSN 1058-4838. JSTOR 27917719. PMID 21342912.
  33. Becasen, Jeffrey S.; Denard, Christa L.; Mullins, Mary M.; Higa, Darrel H.; Sipe, Theresa Ann (2019). "Estimating the Prevalence of HIV and Sexual Behaviors Among the US Transgender Population: A Systematic Review and Meta-Analysis, 2006–2017". American Journal of Public Health. 109 (1): e1–e8. doi:10.2105/ajph.2018.304727. ISSN 0090-0036. PMC 6301428. PMID 30496000.
  34. Meerwijk, Esther L.; Sevelius, Jae M. (2017). "Transgender Population Size in the United States: a Meta-Regression of Population-Based Probability Samples". American Journal of Public Health. 107 (2): e1–e8. doi:10.2105/ajph.2016.303578. ISSN 0090-0036. PMC 5227946. PMID 28075632.
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