Hiv/aids Among Women
CDC HIV/AIDS Fact Sheet
HIV/AIDS among 1-800-CDC-INFO (232-4636)
Women
In English, en Español
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http://www.cdc.gov/hiv
Revised August 2008
Early in the epidemic, HIV infection and AIDS
• High-risk heterosexual contact was the source of
were diagnosed for relatively few women and
80% of these newly diagnosed infections [3].
female adolescents (although we know now that
• Women accounted for 26% of the estimated
many women were infected with HIV through
37,163 diagnoses for adults and adolescents [3].
injection drug use but that their infections were not
diagnosed) [1]. Today, women account for more
• Of the 126,964 women living with HIV/AIDS,
than one quarter of all new HIV/AIDS diagnoses.
64% were black, 19% were white, 15% were
Women of color are especially affected by HIV
Hispanic, 1% were Asian or Pacific Islander, and
infection and AIDS. In 2004 (the most recent year
less than 1% were American Indian or Alaska
for which data are available), HIV infection was
Native [3].
• the leading cause of death for black women
• The number of HIV/AIDS diagnoses among
(including African American women) aged
female adults or adolescents decreased from
25–34 years
11,941 in 2001 to 9,708 in 2005 [3].
• the 3rd leading cause of death for black women • According to a recent CDC study of more than
aged 35–44 years
19,500 patients with HIV in 10 US cities, women
were slightly less likely than men to receive
• the 4th leading cause of death for black women
prescriptions for the most effective treatments
aged 45–54 years
for HIV infection [4].
• the 4th leading cause of death for Hispanic
women aged 35–44.
Sex of adults and adolescents with
In the same year, HIV infection was the 5th
HIV/AIDS diagnosed during 2005
leading cause of death among all women aged 35–
44 years and the 6th leading cause of death among
all women aged 25–34 years. The only diseases
causing more deaths of women were cancer and
heart disease [2].
STATISTICS
HIV/AIDS in 2005 (The following bullets, except for
the last one, are based on data from 33 states with long-term,
confidential name-based HIV reporting.*)
• HIV/AIDS was diagnosed for an estimated 9,708
women [3].
Note. Based on data from 33 states with long-term,
confidential name-based HIV reporting.
*For a list of the 33 states, please refer to the box before the
References.
HIV/AIDS among Women
Transmission categories and race/ethnicity of women living with HIV/AIDS at the
end of 2005
Note. Based on data from 33 states with long-term, confidential name-based HIV reporting.
AIDS in 2005
diagnoses, a number that represents 19% of the
• Of 40,608 AIDS diagnoses in the 50 states and
952,629 AIDS diagnoses in the 50 states and the
the District of Columbia, 10,774 (27%) were for
District of Columbia during this period [3].
women [3].
• From the beginning of the epidemic through
• The rate of AIDS diagnosis for black women
2005, an estimated 85,844 women with AIDS
(45.5/100,000 women) was approximately 23
died, accounting for 16% of the 530,756 persons
times the rate for white women (2.0/100,000)
with AIDS who died in the 50 states and the
and 4 times the rate for Hispanic women
District of Columbia [3].
(11.2/100,000) [3].
• Women with AIDS made up an increasing part
• An estimated 95,959 women were living with
of the epidemic. In 1992, women accounted
AIDS, representing 23% of the estimated
for an estimated 14% of adults and adolescents
421,873 people living with AIDS in the 50 states
living with AIDS in the 50 states and the District
and the District of Columbia [3].
of Columbia [5]. By the end of 2005, this
proportion had grown to 23% [3].
• An estimated 4,128 women with AIDS died,
representing 25% of the 16,316 persons with
• Data from the 2005 census show that together,
AIDS who died in the 50 states and the District
African American and Hispanic women
of Columbia [3].
represent 24% of all US women [6]. However,
women in these 2 groups accounted for 82%
• From the beginning of the epidemic (1981)
(8,807/10,774) of the estimated total of AIDS
through 2005, women accounted for 181,802
diagnoses for women in 2005 [3].
2
HIV/AIDS among Women
Race/ethnicity of women with HIV/AIDS
Diagnosis of HIV/AIDS in
diagnosed during 2005
females aged 15-39 years
2001
2004
No. (%)*
No. (%)*
Asian/Pacific
31 (55)
62 (66)
Islander
American
23 (52)
39 (68)
Indian/Alaska
Native
* Percent (%) of women age 15-39 in corresponding sub-
group.
Lack of Recognition of Partner’s
Risk Factors
Some women may be unaware of their male
partner’s risk factors for HIV infection (such as
Note. Based on data from 33 states with long-term,
confidential name-based HIV reporting.
unprotected sex with multiple partners, sex with
men, or injection drug use) [8]. Men who engage
in sex both with men and women can acquire HIV
from a male partner and then transmit the virus
RISK FACTORS AND BARRIERS to female partners. In a 2003 report of a study
TO PREVENTION
of HIV-infected people (5,156 men and 3,139
women), 34% of black men who have sex with
Younger Age
men (MSM), 26% of Hispanic MSM, and 13% of
For women of all races and ethnicities, the largest
white MSM reported having had sex with women
number of HIV/AIDS diagnoses during recent
[9]. However, these women may not have known
years was for women aged 15–39. From 2001
of their male partner’s bisexual activity: only 14%
through 2004, the number of HIV/AIDS diagnoses of white women, 6% of black women, and 6%
for women aged 15–39 decreased for white, black, of Hispanic women in this study acknowledged
and Hispanic women. There was an increase in the having a bisexual partner. In another CDC survey,
number of HIV/AIDS diagnoses during this period 65% of the young men who had ever had sex
for Asian and Pacific Islander women and for
with men also reported sex with women [10].
American Indian and Alaska Native women aged
Women who have sex only with women and who
15–39 [7].
have no other risk factors, such as injection drug
use, are at very low risk for HIV infection (CDC,
unpublished data, 2006).
Diagnosis of HIV/AIDS in
High-Risk Heterosexual Risk Factors
females aged 15-39 years
2001
2004
Most women are infected with HIV through
No. (%)*
No. (%)*
high-risk heterosexual contact [3]. Black and
Hispanic women account for 81% of the women
White
1,218 (63)
996 (56)
living with HIV/AIDS in 2005 who acquired
Black
5,229 (62)
4,091 (58)
HIV through high-risk heterosexual contact [3].
Hispanic
1,192 (60)
819 (57)
Lack of HIV knowledge, lower perception of risk,
3
HIV/AIDS among Women
drug or alcohol use, and different interpretations
Socioeconomic Issues
of safer sex may contribute to this disproportion
Nearly 1 in 4 African Americans and 1 in 5
[11]. Relationship dynamics also play a role. For
Hispanics live in poverty [20]. Socioeconomic
example, some women may not insist on condom
problems associated with poverty, including
use because they fear that their partner will
limited access to high-quality health care; the
physically abuse them or leave them [12]. Such
exchange of sex for drugs, money, or to meet
sexual inequality is a major issue in relationships
other needs; and higher levels of substance use
between young women and older men. In a CDC
can directly or indirectly increase HIV risk factors
study of urban high schools, more than one third
[21]. A study of HIV transmission among black
of black and Hispanic women had their first sexual women in North Carolina found that women with a
encounter with a male who was older (3 or more
diagnosis of HIV infection were significantly more
years) [13]. These young women, compared with
likely than women who were not infected to be
peers whose partners had been approximately
unemployed; to have had more sex partners; to use
their own age, had been younger at first sexual
crack/cocaine; to exchange sex for money, shelter,
intercourse, less likely to have used a condom
or drugs; or to receive public assistance [22].
during first and most recently reported intercourse,
or less likely to have used condoms consistently.
Racial/Ethnic Differences
Biologic Vulnerability and Sexually
The rates of HIV diagnosis and the risk factors
Transmitted Diseases
for HIV infection differ for women of various
races or ethnicities—a situation that must be
A woman is significantly more likely than a man to considered when creating prevention programs.
contract HIV infection during vaginal intercourse
For example, even though the annual estimated
[14, 15]. Additionally, the presence of some
rate of HIV diagnosis for black women decreased
sexually transmitted diseases greatly increases
significantly—from 82.7 per 100,000 population
the likelihood of acquiring or transmitting HIV
in 2001 to 60.2 per 100,000 population in 2005—it
infection [16]. The rates of gonorrhea and syphilis remained 20 times the rate for white women [3,
are higher among women of color than among
23]. Overall, the rates of HIV diagnosis are much
white women. These higher rates are especially
higher for black and Hispanic women than for
marked at younger ages (15–24 years) [17].
white, Asian and Pacific Islander, or American
Indian and Alaska Native women. The rates for
Substance Use
black women are higher than the rates for all men
An estimated 1 in 5 new HIV diagnoses for
except for black men [3, 24, 25].
women are related to injection drug use [3].
Sharing injection equipment contaminated with
Multiple Risk Factors
HIV is not the only risk associated with substance Some women infected with HIV report more
use. Women who use crack cocaine or other
than 1 risk factor, highlighting the overlap in
noninjection drugs may also be at high risk for the risk factors such as inequality in relationships,
sexual transmission of HIV if they sell or trade
socioeconomic stresses, substance abuse, and
sex for drugs [18]. Also, both casual and chronic
psychological issues. For example, in the North
substance users are more likely to engage in high-
Carolina study of HIV infection in black women,
risk behaviors, such as unprotected sex, when they the participants most commonly reported that that
are under the influence of drugs or alcohol [19].
their reasons for risky behavior were financial
dependence on male partners, feeling invincible,
low self-esteem coupled with the need to feel
loved by a male figure, and alcohol and drug use
[22].
4
HIV/AIDS among Women
PREVENTION
African American women at high risk for HIV
infection.
CDC estimates that 56,300 new HIV infections
occurred in the United States in 2006 [26].
• In Massachusetts, CAB Health & Recovery
Populations of minority races/ethnicities are
Services, Inc., receives funding for HIV risk-
disproportionately affected by the HIV epidemic.
reduction counseling and prevention case
To further reduce the incidence of HIV infection,
management and for Women RISE (Risk
CDC announced a new initiative, Advancing HIV
Identification, Strategies, and Empowerment),
Prevention, in 2003. This initiative comprises
an HIV prevention services program that
4 strategies: making HIV testing a routine part
engages women and their partners who are
of medical care, implementing new models
at very high risk for HIV infection, who are
for diagnosing HIV infections outside medical
homeless and living in family shelters, or who
settings, preventing new infections by working
are identified through street outreach.
with HIV-infected persons and their partners, and
• In California, the Orange County Bar
further decreasing perinatal HIV transmission.
Foundation adapts SISTA for Latinas aged
18–24 years.
In the United States, women, particularly women
• In Florida, the Center for Multicultural
of color, are at risk for HIV infection. CDC,
Wellness & Prevention, Inc., addresses,
through the Department of Health and Human
through SISTA and CTR, the health issues that
Services Minority AIDS Initiative, explores
affect African American and Haitian women.
ways to reduce disparities in communities made
up of persons of minority races/ethnicities who
• In New York, the Community Healthcare
are at high risk for HIV infection. CDC is also
Network provides prevention services through
conducting demonstration projects in which
counseling, comprehensive risk counseling
women’s social networks are used to reach
and referral, and RAPP (Real AIDS Prevention
high-risk persons in communities of color;
Project) interventions to African American and
CDC is also conducting outreach and testing for
Hispanic women.
partners of HIV-infected men. Additionally, CDC
recognizes the importance of further incorporating CDC also funds research on interventions to
culture- and gender-relevant material into current
reduce HIV-related risk behaviors or their
interventions [27].
outcomes. For example, the Women and Infants
Demonstration Projects were focused on low-
CDC funds prevention programs in state and
income, inner-city sexually active women to
local health departments and community-based
measure injection drug use, sexual behaviors,
organizations. The following are examples.
and rates of HIV testing, as well as sexually
transmitted diseases and pregnancy. The
• In Illinois, Access Community Health
demonstration projects increased condom use and
Network, which is the largest network of
resulted in the RAPP intervention package, which
community health centers in the nation,
is available, along with training and technical
receives funding to implement counseling,
assistance, from CDC.
testing, and referral (CTR) in Chicago
communities with the highest rates of HIV
CDC is actively involved in the promising area
diagnosis and funding to implement SISTA
of microbicides—creams or gels that can be
(Sisters Informing Sisters about Topics on
applied vaginally before sexual contact to prevent
AIDS), a social-skills training program aimed
HIV transmission. The development of a safe,
at reducing HIV sexual risk behavior among
easy-to-use microbicide would be a milestone in
the worldwide fight against HIV/AIDS. CDC is
5
HIV/AIDS among Women
supporting the search for an effective microbicide
agent through several lines of research, including
Understanding HIV and AIDS Data
• conducting laboratory and animal studies that
AIDS surveillance: Through a uniform system, CDC
receives reports of AIDS cases from all US states and
can help evaluate the safety and the efficacy
dependent areas. Since the beginning of the epidemic,
of microbicides before they are studied in
these data have been used to monitor trends because
humans.
they are representative of all areas. The data are statisti-
cally adjusted for reporting delays and for the redistri-
• supporting clinical trials to assess the safety of
bution of cases initially reported without risk factors.
microbicides in humans in the United States,
As treatment has become more available, trends in new
AIDS diagnoses no longer accurately represent trends
Asia, and Africa. Current human clinical
in new HIV infections; these data now represent per-
studies include a phase I safety trial of UC-
sons who are tested late in the course of HIV infection,
781, which is being conducted among women
who have limited access to care, or in whom treatment
has failed.
in the United States and Thailand.
HIV surveillance: Monitoring trends in the HIV
To reduce mother-to-child HIV transmission in the
epidemic today requires the collection of informa-
tion on HIV cases that have not progressed to AIDS.
United States, CDC has distributed approximately
Areas with requirements for confidential name-based
$10 million annually since 1999 to several national
HIV infection reporting use the same uniform system
organizations and a number of states with high
for data collection on HIV cases as for AIDS cases. A
total of 33 states (Alabama, Alaska, Arizona, Arkan-
HIV/AIDS rates. These funds support perinatal
sas, Colorado, Florida, Idaho, Indiana, Iowa, Kansas,
HIV prevention programs, enhanced surveillance
Louisiana, Michigan, Minnesota, Mississippi, Missouri,
for HIV-infected mothers and babies, education,
Nebraska, Nevada, New Jersey, New Mexico, New
and capacity building among health care providers
York, North Carolina, North Dakota, Ohio, Oklahoma,
South Carolina, South Dakota, Tennessee, Texas, Utah,
and public health practitioners.
Virginia, West Virginia, Wisconsin, and Wyoming) have
collected these data for at least 5 years, providing suf-
ficient data to monitor HIV trends.
HIV/AIDS: This term is used to refer to 3 categories of
REFERENCES
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For more information . . .
CDC HIV/AIDS
CDC National Prevention Information
http://www.cdc.gov/hiv
Network (NPIN)
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1-800-458-5231
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CDC-INFO
CDC resources, technical assistance, and
1-800-232-4636
publications
Information about personal risk and where to
get an HIV test
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CDC National HIV Testing Resources
http://www.aidsinfo.nih.gov
http://www.hivtest.org
Resources on HIV/AIDS treatment and
Location of HIV testing sites
clinical trials
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