Medicine: AIDS And Women

More than 90% of American AIDS victims have been men, most of them white homosexuals. Yet in black and Hispanic neighborhoods, particularly in East Coast inner cities, the epidemic presents a very different picture. There, AIDS is a disease of both males and females; most victims are drug users, but many are either lovers or offspring of addicts. With growing frequency in these communities, the deadly infection is passed through ordinary heterosexual intercourse. This much neglected fact was a principal finding in a study conducted at the Centers for Disease Control in Atlanta and published % in last week’s Journal of the American Medical Association.

The research, carried out by Epidemiologists Ann Hardy and Mary Guinan, focused on nearly 2,000 reported cases of AIDS in women. Though women account for less than 7% of all U.S. AIDS victims, their cases have a special significance, according to the authors. By studying these cases, researchers can get clues about how rapidly the disease is spreading among heterosexuals and among children, most of whom contract AIDS from infected mothers. More than half the women studied (52%) were infected through intravenous use of drugs. But the second largest group, and the fastest-growing by far, consisted of women infected through sexual intercourse with infected men. Between 1982 and 1986 the proportion of women who contracted AIDS via sex with men rose from 12% of all female AIDS cases to 26%.

No less striking was the study’s finding that more than 70% of AIDS cases in women occurred among blacks and Hispanics. Indeed, a woman who is black is 13 times as likely as one who is white to fall victim, and 90% of infants born with AIDS are black or Hispanic. These statistics primarily reflect the larger number of intravenous drug users among these groups and less awareness of how to prevent AIDS infection. “The minorities, the low-income groups,” says Hardy, “have always been difficult to reach.”

In an editorial accompanying the study, Dr. Constance Wofsy of the University of California, San Francisco, warns that “all sexually active women” face potential risk of AIDS but criticizes the media for supporting the “misimpression that AIDS in heterosexuals is a white disease.” Wofsy calls for greater efforts to bring AIDS education to the poor and to drug users in particular, but acknowledges the difficulty of getting the message across: “The potential future danger of AIDS is less compelling ((to them)) than the day-to-day problems of poverty and drug use.” For these people, she and other public-health officials advocate less moralizing about the benefits of abstinence and more practical education about the importance of clean needles and the use of condoms to protect against infection.