Women Living With HIV/AIDS: What are the issues? By Sara Henderson
From: Alice - August 2004, Volume 7, Issue 8
To support women living with HIV/AIDS an increased range of information must be developed. How does our culture define 'women's health' anyway? Many have described it in the past as relating to only the reproductive system and the breast, a sort of 'bikini view' of the needs of the female patient as compared to a total assessment of a woman's unique features and needs. Women have lower rates of early HIV detection and treatment, and because of this there are gender differences in survival and mortality.
These imbalances are a result of many issues, such as decreased opportunities to access care and a lesser involvement in clinical trials or research. Women may take less time to care for themselves because of the responsibilities they have as mothers and caregivers. Other reasons for women's lesser health status may be caused by a sense of helplessness, poverty, shame and a male dominated medical system from which they feel alienated. Healthcare professionals and HIV/AIDS key decision makers must hear and understand the influence these issues are having on HIV+ women's health situations.
The World Health Organization claims that there are 33.6 million people living with HIV/AIDS, 14.8 million of whom are women. This shows an increased need for investigation into what may be affecting the health of HIV+ women. To what extent does the societal, economic and political status of women influence their health? The effects that anti-HIV medications may have on women, as well as a variety of other women's health issues must be examined to improve women's qualities of life. The majority of women infected with HIV are in their child bearing years and with improvements in HIV therapy, many think about having children. With good HIV care, the risk for perinatal spread is small (less then 2%). Women who make the choice to have children must be supported.
The success of new medications is resulting in prolonged life, which is wonderful, but does lead to a new set of concerns. Many women are experiencing menopause combined with HIV symptoms and the negative side effects of HIV medications: is it a hot flash or a symptom of the disease process, or a reaction to the medications? HIV+ women may face menopause at an earlier age, possibly due to: reduced hormone production; decreased circulating red blood cells; weight loss and HIV medications. Also, there are concerns with women-specific conditions like menstrual problems, vaginal infections, cervical cancer and pelvic inflammatory disease, which can be more common in HIV+ women. Because of these concerns the need for increased medical testing is important (eg. pap smears every 6 months). There is a lack of knowledge about the complications of HIV among older women, but it is possible that complications linked with HIV medications, such as loss of bone mass, heart disease and mental dysfunction will become increasingly significant health concerns. The unique real life health issues of HIV+ women must become less invisible to the key players who influence HIV/AIDS policy and research to facilitate a change in the negative gender differences that do exist for women living with HIV/AIDS.
Sara Henderson is a nursing practicum student with VARCS for part of the summer. We thank Sara for the researching and writing she has done in preparing this article.
Here are some resources available that provide helpful information relating to HIV/AIDS and women's health:
Vancouver Island Persons Living With HIV/AIDS Society (VIPWAS): 382 - 7927 #330 - 1105 Pandora Avenue (at Cook Street). www.vpwas.com
Positive Women's Network: #1-866-692-3001 or www.pwn.bc.ca (support services & treatment information for women)
BC Centre for Excellence in HIV/AIDS: www.cfeweb.hivnet.ubc.ca (treatment information)
BC Persons with AIDS Society: #1-800-994-2437 (treatment information)
Canadian AIDS Treatment Information exchange: # 1-800-263-1638 or www.catie.ca