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- Women
- Minority Women
- Young Women
- What do “kids” consider sex?
- Women Over 50
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HCET Home > On-line Training > HIV Risk Assessment in Women > HIV/AIDS Epidemiology
1. HIV/AIDS Epidemiology
What’s Happening in the United States?
Approximately 40,000 new HIV infections occur annually. (1)
- 70 % among men and 30 % among women (1)
- 50% of all new infections are among individuals under the age of 25 (2)
Estimated 850,000 to 950,000 are living with HIV. (4)
- 25% of these individuals are unaware of their infection (1)
At the end of 2001, CDC reported:
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Figure
1:Women
- An estimated 14,000 U.S. women become
infected with HIV each year.
(4)
- Over 45,000 women between the ages of 15
and 44 were reported to be living with AIDS at the end of 2001.
(3)
- From 1985 to 2000, the percentage of women living with AIDS increased from 7% to 25%. (4)
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- Among new infections, the CDC estimates the following distribution of infection:
- 75 % infected through heterosexual sex
- 25 % infected through injection drug use
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Minority Women
The HIV/AIDS infection rate for minority persons has shown a steady increase since the beginning of the epidemic. Minority populations in the U.S. now constitute over half of all AIDS cases reported. (5) African American and Hispanic women are considered to be the fastest growing population of HIV infections.
- HIV is the second leading cause of death for African American women ages 25-44.
- HIV is the third leading cause of death for Hispanic women ages 25-44.
(6)
- African-American women accounted for
nearly 64% of all HIV cases reported among women in 2001. (5)
- Latino women accounted for nearly 17% of all HIV cases reported among women in 2001. (5)
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- AIDS has disproportionately affected minorities in the U.S. Although whites comprise the greatest percentage of the U.S. population, minorities account for the greatest percentage of AIDS cases. (5)
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What are the contributing factors for HIV infection among minority women?
- Minority women are less likely to receive regular health care and are less likely to be tested for HIV.
- Minority women have high rates of sexually transmitted infections (STI).
- If an STI is present, the chance of getting HIV (if exposed) is increased 2-5 times.
- Language and cultural barriers may prevent women from seeking medical care or receiving prevention messages.
(7)
More
information about Minority women and HIV:
- CAPS Fact Sheet - What Are U.S. Latinos’ HIV Prevention Needs?
-
CDC Fact Sheet -
HIV/AIDS Among Hispanics in the United States
- CDC Fact Sheet - HIV/AIDS Among U.S. Women: Minority and Young Women at Continuing Risk
- CDC's
HIV/AIDS AMONG AFRICAN AMERICANS
KEY FACTS - The Impact of HIV Infection
Young Women and HIV Infection
- In the U.S., at least one-half of all new HIV infections occur in people less than 25 years of age.
- Two people under the age of 25 are infected with HIV every hour of the day.
- As of 2000, females represented 61% of the total AIDS cases in the 13 to 19-year-old age group and 42% of AIDS cases in the 20 to 24-year-old age group.
(2)
- HIV infection in females is more prevalent in the adolescent years than the young adult years. Factors that may be related to the increased HIV prevalence rate in adolescence include:
- being more biologically vulnerable to STI/HIV,
- being less capable of negotiating safer sex with an older partner,
- a feeling of invincibility, or a greater concern for pregnancy prevention than prevention of STI/HIV. (8)
Activity: Examine the following slide and observe the difference in infection rates of men and women as they get older. With respect to your female clients, how many of them have older sex partners?
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- As with women, minority adolescents are disproportionately affected by AIDS. Unfortunately, as we examine the trend of infection rates for minority youths with HIV, it is likely that this pattern will continue.
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What do “kids” consider sex?
- Health care providers, parents, and the general public often underestimate sexual activity among adolescents. Many surveys designed to capture sexual activity ask only about sexual intercourse, which is not well defined and is left to interpretation by the subject.
- As with most adults, many teens do not consider oral or anal sex as sexual intercourse. Despite the national attention regarding “oral sex,” many still believe that oral sex is not really sex. Children are having oral sex as early as middle school and do not consider themselves sexually active or at risk for STI/HIV.
(9)
- Another activity in which teens are participating is anal sex. One study showed that 20% of females and 27% of males age 13-19 have had anal sex.
(10) The Urban Institute conducted a study of 15-19 year-old boys and 2/3 reported having had oral or anal sex.
(11)
- The Youth Risk Behavior Survey is a national survey designed to measure health risk behaviors. Most states participate and data are collected for many behaviors including sexual intercourse. Keep in mind that the survey does not define sexual intercourse!More
information about young women and HIV:
- YRBSS - Youth Risk Behavior Surveillance System
- CDC Fact Sheet - Young People at Risk: HIV/AIDS Among America’s Youth
- NIAID Fact Sheet - HIV Infection in Adolescents
Women Over 50
- Although women over the age of 50 are not generally family planning clients, this section provides information for those individuals who may provide care for women over 50 and may be at risk for HIV infection.
- AIDS cases in women over the age of 50 have more than doubled from 1995 to 2001.
- As of 2001, women over the age of 50 accounted for 14,117 AIDS cases.
- CDC estimates that 14% of all U.S. HIV infections occur in people over 50.
- Very few prevention messages are aimed at mature women.
- Several factors contribute to the risk of older women.
- Many people assume that older people are immune to HIV/AIDS -- including older Americans themselves.
- Physicians are reluctant to discuss sexual activity with this age group. Studies indicate that 40% of primary care physicians do not assess HIV risk in people over 50.
- Women over 50 are generally are not concerned with pregnancy prevention and do not think of condoms as anything else.
- As a woman ages, the vaginal canal becomes thinner and more likely to tear. She may also have a decrease in vaginal lubrication. Both factors increase risk.
- Products such as Viagra, increase sexual activity in the older population and are often prescribed without discussing HIV prevention techniques
- To combat the spread of HIV/AIDS among this population, the National Institute on Aging (NIA) recommends that doctors and other health care professionals
- Provide patients over the age of 50 with information on HIV transmission and at-risk behavior.
- Review a patient's sexual and substance use history.
- Encourage voluntary HIV testing and provide risk reduction counseling.
- People over 50 are less likely to receive an early diagnosis than younger people, allowing HIV to progress undiagnosed.
- HIV testing can rule out HIV disease as the cause of some effects of aging such as night sweats and depression. (12)
For more information, click on the following web sites
- The National Association of People over Fifty
- Rural Center for AIDS/STD Prevention Fact Sheet:
Older Adults and HIV/AIDS
Women Who Have Sex with Women
- Female-to-female transmission of HIV is a rare occurrence. However, case reports of female-to-female transmission of HIV and the well-documented risk of female-to-male transmission of HIV indicate that vaginal secretions and menstrual blood are potentially infectious and that mucous membrane (e.g., oral, vaginal) exposure to these secretions has the potential to lead to HIV infection.
(13)
For more information, click on the following websites:
