In its relatively short but devastating history in the United States, AIDS (acquired immunodeficiency syndrome) has been considered primarily the scourge of gay men, intravenous drug users and recipients of contaminated blood during transfusion. But it has revealed itself as less selective. Now statistics are building to support the growing concern of its spread to women. According to the Centers for Disease Control, the number of heterosexually transmitted AIDS cases in the U.S. has increased from less than 3 per cent in 1986 to approximately 6 percent now. And from 1981 through October 1991, the same agency has reported 10,850 heterosexually transmitted AIDS cases. Of those, 6,883 are women 13 years of age and older.
Joseph O`Connell, a psychologist and director of Personal Diagnostics, a private service in New York that counsels and tests for HIV, the virus that causes AIDS, said, ”Many women were heterosexually active with several partners over the last 10 or 15 years. Now at the ages of 35 to 40, they are considering pregnancy, but are frightened that they have been infected by a man whose sexual history is unknown to them. He may have been in a high-risk category.”
AIDS, a disease in which the immune system is destroyed, is believed to be caused by an HIV (human immunodeficiency virus) infection. AIDS victims are severely debilitated and can experience extreme weight loss, several types of cancer, brutal infections, central nervous system deterioration and dementia. And because there is no cure, it is vital, experts say, to take all available preventive measures, including testing.
”From the time an individual is exposed to HIV to the time of potential infection and development of a positive antibody test result can be 10 days to 6 months,” said Dr. Kathleen Squires, assistant professor of medicine, Cornell University Medical College in New York.
Unfortunately, it is difficult to predict when an HIV-positive individual will develop full-blown AIDS. Researchers say there is an average of 10 years between infection with the virus and development of the disease. However, it can occur much earlier, as soon as a year or several years after the 10-year mark.
Among women, blacks and Hispanics are at the greatest risk due to a disproportionate amount of risk factors-infected by intravenous (IV) drug abuse or sexual contact with an IV drug abuser. But any woman, regardless of race, ethnic background or economic status, is susceptible to the virus.
Women also should be aware that, although exact numbers are not available, there is a higher incidence of women becoming HIV-infected by men from vaginal intercourse than from women to men. According to the Gay Men`s Health Crisis Inc., a New York-based counseling and information center, there are higher concentrations of HIV in sperm than in vaginal secretions, but the mode of transmission into the bloodstream is still uncertain.
Squires said some European studies have shown that the chance of getting the virus does increase if a woman has a sexually transmitted disease at the time she is exposed to an HIV-infected man.
”With an STD there is some kind of genital ulcer or open lesion with white cells in the area responding to the local infection,” Squires said.
”Therefore, if the open lesion is exposed to HIV, the virus can infect the white cells or it can enter the system through the opening or wound.”
According to ”What Women Need to Know about AIDS,” a pamphlet prepared and distributed by the Gay Men`s Health Crisis, women can spread HIV to their unborn children or to newborns via breast milk.
Any woman, whether or not she is planning a pregnancy, should obtain a blood test for HIV if she has a history of or is presently participating in high-risk behavior; for instance, having unprotected vaginal or anal intercourse, or oral sex with an individual she knows or suspects is HIV-positive. Also, an intravenous drug user or a sexual partner of such a drug user-or just anyone who is concerned-should undergo testing.
Furthermore, the pamphlet states, testing also is advised for women who have early symptoms of HIV infection, which can include extreme tiredness, fever, chills, night sweats, swollen glands in the neck, armpits and groin, sudden and extreme weight loss of more than 10 pounds without dieting, chronic diarrhea, dry cough (not caused by smoking) and persistent discolored or purplish flat or raised blotches on or under the skin, inside the mouth, nose, eyelids or anus.
Also, chronic gynecological infections that don`t respond to standard treatment-recurrent yeast or other vaginal infections, chronic herpes or genital sores or warts, or abnormal Pap smears could be symptoms.
Squires added that a major advantage to knowing if you`re HIV-positive is that early intervention with anti-HIV therapy can slow the progression of the infection. The two drugs that have been approved by the Food and Drug Administration are AZT, or azidothymidine, and more recently DDI, or didanosine.
Psychologist O`Connell said an individual interested in obtaining HIV testing should seek a facility that guarantees anonymity because of the stigma attached to a positive result. Private physicians and hospitals may include the results in medical records, he said. The person to be tested should also ask about an AIDS counselor`s credentials.
Private physicians` fees vary. Howard Brown Memorial Clinic in Chicago charges $60. Free, anonymous testing is available at city and county health department clinics. At Chicago and Cook County public aid clinics, for example, the person to be tested is not asked his or her name, but is given a code number. The person must return to pick up the results, using the code number to obtain them. Waiting periods for appointments also vary.
The best known protection from HIV is to practice safer sex with latex condoms, O`Connell said: ”Women need to be more assertive when it comes to getting a man to wear a condom-a common problem, and they should always take a condom along on a date,” O`Connell said.
Myths to be discarded in regard to AIDS include those that warn that it can be spread through coughing, sneezing, kissing, touching doorknobs or telephones or toilet seats. It can be spread through sexual contact.
Here is some advice from ”Women Need to Know About AIDS” for practicing safer sex:
– Always wear latex condoms during oral, vaginal and anal sexual intercourse and use them throughout the sexual encounter, because HIV could be present in pre-seminal fluid. Condoms also should be used on sex toys.
– Do not use lambskin and other ”natural membrane” condoms, as the HIV could seep through.
– With a latex condom, always use spermicidal lubricants, preferably with nonoxynol-9 to increase protection. Use only water-based jellies or lubricants. Lubricants with oil, grease or alcohol can damage condoms.
– Withdrawal before ejaculation is recommended; always discard the condom after it is used.
– For women who may be infected, dental dams (squares of latex) can be spread over the vagina, clitoris and anus during oral sex.
To obtain a free copy of the pamphlet, ”Women Need to Know about AIDS,” write to the Gay Men`s Health Crisis Inc., 129 W. 20th St., New York, N.Y. 10011, or call the organization`s hotline: 212-807-6655.
For a copy of ”Not by Kissing,” a pamphlet offered by the Cook County Department of Public Health, call 708-865-4857. Other resources include: the Chicago Women`s AIDS Project, 312-271-2070; Howard Brown Memorial Clinic, 312-871-5777; the City of Chicago Department of Public Health, 312-744-4312;
the State of Illinois AIDS hotline, 800-243-2437; and the national AIDS hotline, 800-342-2437.
