HIV/AIDS in Women: An Expanding Epidemic

Quinn, Thomas C.
Overbaugh, Julie

¹Laboratory of Immunoregulation, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD 20892, USA. ²Departments of Medicine, Epidemiology, and International Health, Johns Hopkins Medical Institutions, Baltimore, MD 21205, USA. ³Division of Human Biology, Fred Hutchinson Cancer Research Center, Seattle, WA 98109, USA.

*To whom correspondence should be addressed. E-mail: [email protected]

10.1126/science.1112489

Science 308(5728):p 1582-1583, June 10, 2005.

More than 20 years into the human immunodeficiency virus-type 1 (HIV-1) epidemic, women account for nearly half of the 40 million people living with HIV-1 worldwide, with an even higher proportion existing in developing countries. Social determinants of female vulnerability to HIV-1 include gender disparities, poverty, cultural and sexual norms, lack of education, and violence. Women are also more susceptible to HIV-1 because of hormonal changes, vaginal microbial ecology and physiology, and a higher prevalence of sexually transmitted diseases. Prevention strategies must address the wide range of gender inequalities that promote the dissemination of HIV-1.