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Women of Color and HIV

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HIV in US Communities of Color

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Abstract

In the early years of the HIV/AIDS epidemic, women represented a very small proportion and number of those with HIV or AIDS in the United States. The proportion of new HIV/AIDS cases in women increased from 8% of all cases in 1985 to 27% in 2005 and has been declining for several years now, and was 19% of all US cases in 2017. Women of color have borne the brunt of the epidemic among women for several decades. Black and Hispanic women now account for approximately 75% of new HIV/AIDS diagnoses in women. Numerous psychosocial, socioeconomic, and health system factors, including poverty, higher rates of other sexually transmitted diseases, societal structural issues including racism and sexism, low perception of risk, and lack of access to care and treatment, have led to the disparate rise in HIV infection in women of color. For similar reasons, increasing numbers of HIV cases have also been noted in women worldwide. Globally, women represent more than one-half of all infections among adults and are the fastest growing population living with HIV.

Much of the information about HIV/AIDS that was published early in the epidemic was based on the data collected from male-predominant cohorts. As the demographics of the epidemic changed, so did the need for research studies investigating the impact of HIV on women. In the early 1990s, research cohorts comprising women were formed. Prospective studies from these longitudinal cohorts and independent research have contributed to an improved understanding of gender-based differences in HIV infection. We now have a better understanding of the environmental factors that impact disease progression in women, gender-specific side effects and toxicities caused by antiretroviral therapy (ART), and the gynecologic manifestations specific to HIV. Our knowledge of the unique impact that HIV has on women, particularly on women of color, continues to evolve.

This chapter serves as a reference tool to provide clinical guidance to providers caring for women living with HIV infection. Risk factors for acquiring HIV will be reviewed, as will the natural history of HIV infection with and without treatment. Clinical management strategies will be discussed, and the unique aspects of caring for women living with HIV, including the management of women on HAART, will be outlined. The gynecologic manifestations of HIV will be reviewed and a brief review of reproductive challenges that women living with HIV face will be provided as well.

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Authors and Affiliations

  1. Legacy Community Health Center, Houston, TX, USA

    Charlene A. Flash

  2. Baylor College of Medicine, Houston, TX, USA

    Charlene A. Flash & Syundai R. Johnson

  3. Divisions of General Internal Medicine, Division of Infectious Diseases, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA

    Valerie E. Stone

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  1. Charlene A. Flash
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  2. Syundai R. Johnson
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Correspondence to Valerie E. Stone .

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  1. Division of Global Health Equity, Division of Infectious Diseases, Department of Medicine, Brigham and Women’s Hospital Harvard Medical School, Boston, MA, USA

    Bisola O. Ojikutu

  2. Division of General Internal Medicine, Division of Infectious Diseases, Department of Medicine, Brigham and Women’s Hospital Harvard Medical School, Boston, MA, USA

    Valerie E. Stone

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Flash, C.A., Johnson, S.R., Stone, V.E. (2021). Women of Color and HIV. In: Ojikutu, B., Stone, V. (eds) HIV in US Communities of Color. Springer, Cham. https://doi.org/10.1007/978-3-030-48744-7_6

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