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HIV Increasing Faster Among Women Than Men, Report Finds

By David Brown
Washington Post Staff Writer
Wednesday, November 24, 2004; Page A03

The epidemic of human immunodeficiency virus infection is growing more rapidly in women than in men in almost every part of the world, according to a new report.

The "feminization" of AIDS appears to reflect a maturing of the epidemic, suggest the authors of the annual AIDS update prepared by the United Nations, the World Health Organization and the World Bank. More and more seemingly low-risk women, many of them married, are being infected by men who acquired the virus through high-risk behavior years ago.

Princess Mbatha and her son Johannes, who are both HIV-positive, wait for free antiretroviral treatment in Soweto, South Africa. In that nation, women ages 15 to 24 are three to six times more likely to be infected than young men. (Themba Hadebe -- AP)

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The trend is most advanced in sub-Saharan Africa, where the AIDS epidemic began and home to more than half the world's HIV-infected population. Women there now make up 57 percent of people living with the virus.

From 2002 to 2004, the percentage of infected women rose or stayed the same in all regions.

"This is an emerging pattern. . . . This has profound implications," said Peter Piot, a Belgian physician and epidemiologist who heads UNAIDS. "We have to put women at the heart of the response to AIDS if we want to stop this epidemic."

The evolving risk to women is a main theme in the 87-page report that paints a mosaic portrait of the global AIDS epidemic.

In all, 39.4 million people are infected with HIV now, up from 37.8 million last year. About 3.1 million died of AIDS-related causes in 2004, out of about 55 million deaths from all causes worldwide.

About 25.4 million people in sub-Saharan Africa are infected, about 7.4 percent of all adults. The Caribbean has the next-highest prevalence, with 440,000 people infected, 2.3 percent of all adults. The prevalence is below 1 percent in both China and India, but the epidemic in those areas is expanding and could become explosive.

The growing proportion of infected women reflects the cumulative effect of many risks. They include the fact that women and, in particular, teenage girls, are more physiologically vulnerable than men; the inability of many women to require their partners to use condoms; the infidelity of husbands and the high-risk behavior of other male partners; the exploitation of young women by older men, especially in southern Africa; and rape and other forms of sexual coercion.

In South Africa, Zambia and Zimbabwe, women ages 15 to 24 are three to six times as likely to become infected as young men. In the Caribbean, the risk for young women is twice that of men.

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© 2004 The Washington Post Company


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