Evidence is emerging that indicates some populations of women are lagging behind in our efforts to prevent HIV (Human Immunodeficiency Virus).
Recently the Public Health Agency of Canada (PHAC) released a summary of HIV infections in Canada. Canada had 595 new HIV infections among females in 2014. This estimate represents 23.2% of all new infections. The majority of these women (79.2%) acquired their infection through heterosexual contact and the remainder (20.2%) through intravenous drug use.
Undiagnosed males and females living with HIV was highest in those who acquired their infection through heterosexual contact. Being unaware of HIV status is problematic for several reasons. It contributes to the transmission of the virus to others and the lost opportunity for early HIV treatments known to increase life expectancy.
In Chatham-Kent from 2005 to 2015 inclusive we had 17 cases of HIV of which five cases were in females.
Why are Women Affected by HIV?
So why are women at risk? Two reasons, biology and social factors.
The vagina and the cervix have a much greater surface area then main routes of infection for heterosexual men (foreskin and urethra). This large surface area together with a significant amount of seminal fluid remaining in the vagina after sex results in longer and larger exposure to the virus.
In addition, the thin layer of cervical cells and cervical conditions contribute to this exposure.
Normally healthy bacteria protect the vagina from infection. However, these bacteria are often disturbed by a common condition called bacterial vaginosis (BV). BV increases transmission risk of HIV as well as other sexually transmitted infections (STI’s). Both BV and STI’s increase the vulnerability to the vaginal mucous membranes.
While all women are potentially at risk of HIV infection, women with social vulnerabilities face increased risks.
Women who experience sexual violence or coercion are less able to protect themselves when forced into unwanted situations.
Women living in poverty are less likely to challenge their sexual partners if they and their children depend on them for support. A women’s health depends on her partners’ willingness to use condoms. We also know that certain groups of women are particularly vulnerable to social issues.
Newcomer women to Canada are less likely to receive adequate preventative medical care. Statistics show that Aboriginal women, African and Caribbean women from HIV-endemic countries and women in federal prisons are more vulnerable than the general population of women in Canada.
Until these social determinants are addressed, education and individual risk reduction strategies remain important. These strategies include awareness and education, abstinence, limiting the number of sex partners, condom use, sharing information on sexual history with partners and testing prior to new relationships.
