Reports on HIV/AIDS: 1990

NOVEMBER 30, 1990, MMWR, Vol. 39, No. 47, pp. 845-846
AIDS in Women - United States
In the United States, the number of acquired immunodeficiency syndrome (AIDS)
cases reported in women has been steadily increasing. In addition, AIDS cases in
women account for an increasing proportion of all AIDS cases in the United States. By
the end of 1990, reports to CDC of AIDS cases among women will exceed 15,000.
From November 1989 through October 1990, women accounted for 11% of all reported cases in adults; from 1988 to 1989, diagnosed cases increased by 29% in
women, compared with 18% in men. By 1987, AIDS was the eighth leading cause of
death in women aged 15-44 years; based on current trends, AIDS will be among the
five leading causes of death in this population in 1991 (71).
Human immunodeficiency virus (HIV) infection disproportionately affects women
in racial/ethnic minority groups. Although black and Hispanic women constitute 19%
of all U.S. women, they represent 72% of all U.S. women diagnosed with AIDS. In
1988, the death rate from HIV infection was nine times higher for black than for white
women (1). These disproportionate rates largely reflect the occurrence of HIV
infection among injecting drug users and their sex partners.
Although all states have reported AIDS in women, annual rates for states vary
markedly. From November 1989 through October 1990, 4.3 cases were reported per
100,000 women in the United States. Five areas (the District of Columbia, Florida, New
Jersey, New York, and Puerto Rico) reported >10 cases per 100,000 women.
Among all cases of AIDS in women, 85% occurred among women of childbearing
age (15-44 years). Approximately one fourth of these women were 20-29 years of age
at the time of diagnosis; many were probably infected as teenagers.
Reported By: Div of HIV/AIDS, Center for Infectious Diseases, CDC.
Editorial Note: Many women in the United States are unaware they are at risk for HIV
infection, and HIV-infected women often remain undiagnosed until the onset of AIDS
or until a perinatally infected child becomes ill. Many women with HIV infection are of
lower socioeconomic status; therefore, prevention efforts, health care, and social
services-including those for drug treatment-rely on public resources.
During 1991, in collaboration with state and local health agencies, CDC will
continue to strengthen programs to prevent HIV transmission in women. These
programs will 1) further define the risk factors for transmission and the natural history
of disease in HIV-infected women; 2) study factors that facilitate or inhibit condom
use and incorporate study findings into HIV-prevention strategies; 3) continue to
assess women's knowledge of their HIV-risk status and its role in the use of health
services; and 4) expand targeted HIV-intervention activities at selected sites. In
addition, CDC will continue to collaborate with the U.S. Agency for International
Development, the World Health Organization, other international agencies, and other
countries to better understand and prevent HIV infection worldwide.
These efforts will assist in decreasing the occurrence of HIV infection and AIDS
among women and increase the number of women who receive HIV-prevention
services, early counseling and HIV detection, and referral to medical and support
services. Prevention of HIV infection in women is critical for the control of the HIV
epidemic in the United States and throughout the world.
Reference
1. Chu SY, Buehler JW, Berkelman RL. Impact of the human immunodeficiency virus epidemic
on mortality in women of reproductive age, United States. JAMA 1990;264:225-9.

127