In a phenomenon known as the “feminization of AIDS,” women have become the predominant victims of the human immunodeficiency virus in recent years, according to several speakers at a lecture held at Dartmouth-Hitchcock Medical Center on Friday. The talk, titled “The Forgotten Epidemic: AIDS in the 21st Century,” featured several experts in HIV research and was the culmination of a three-day conference sponsored by the National Institute of Allergy and Infectious Diseases.
While men have traditionally been the primary targets of HIV, 80 percent of newly-diagnosed worldwide HIV cases were women in 2007, according to Dartmouth Medical School professor Chuck Wira. In some countries, women may comprise up to 95 percent of people newly-infected with HIV, Wira said.
Approximately 33.4 million people across the globe are currently living with HIV/AIDS, Wira said, and the problem is not limited to less-developed countries, as some areas of Washington, D.C., feature HIV rates comparable to those of some African countries.
Over half of new HIV infections in the United States come from the 25 percent of HIV carriers who are unaware they are infected, according to Susan Cu-Uvin, a professor at Brown University’s Warren Alpert Medical School.
“We have not been able to bring down the number of new infections in the [United States],” Cu-Uvin said. “We have failed.”
It is possible that a woman’s hormones affect her susceptibility to the HIV virus, Wira said. He added that a woman’s reproductive tract faces an unusual challenge because it must protect against pathogens but also support foreign sperm.
Scientists have hypothesized that women are most susceptible to the HIV virus from the onset of ovulation to just before menses, Wira said. During this time the immune system in the female reproductive tract is “dampened down” so the fertilized egg won’t be rejected, he said.
“It’s a biologically important process that we think the virus may have taken advantage of,” Wira said.
Several factors — including ethnicity, lifestyle and previous exposure to sexually transmitted diseases — put individuals at increased risk for contracting HIV, according to Charu Kaushic, a professor at McMaster University Medical School.
Although 80 percent of virus transmission is sexual, HIV transmission is “quite inefficient,” Kaushic said. The male-to-female transmission rate is between one out of 200 and one out of 2,000, although this rate can be much higher if the transmitting individual has only recently been infected by the virus, according to Kaushic.
Any condition that causes genital inflammation — such as a previous STD or bacterial vaginosis — increases an individual’s susceptibility to HIV, according to Kaushic.
Scientists have found that circumcision resulted in a 50 to 54-percent decrease in HIV susceptibility among men in Uganda, Kaushic said. Scientists have not yet found a comparable procedure for women, he said.
Dawn Averitt Bridge, founder and president of the Board of the Well Project, shared her experience as a woman diagnosed with HIV at the talk. The Well Project is a nonprofit organization that seeks to educate women about preventing HIV and supports women living with the virus, according to its website.
Bridge said she was diagnosed with HIV in 1988 at age 19, after originally being diagnosed with Hodgkin’s lymphoma after suffering from swollen lymph nodes. She was not diagnosed with HIV until she requested an HIV test, which the doctor initially refused. When she was finally given the test, it came back positive.
“That was the beginning of shame and stigma of the highest order,” Bridge said. “[The doctor] told me not to tell my brothers.”
Bridge said she decided to continue her education after her diagnosis and transferred to a school closer to home.
“Life expectancy in 1988 was like six months,” Bridge said. “My first goal was to live until [age 20].”
Bridge has since become an activist for AIDS victims and is now married with two children, both of whom are HIV-negative.
“[Science] gave me an opportunity to live a life that I never expected to have with HIV,” Bridge said. “We still have a lot to do to help people understand the impact of HIV and to protect future generations.”