As discussed elsewhere in this manual the introduction of antiretroviral therapy (ART) has meant that positive people who have access to this therapy have the chance of increased good health, quality of life and life expectancy. However, adherence to ART can be difficult both in terms of the side-effects associated with some of the medications and in terms of the side-effects of treatment.

Since most trials of drugs have to date occurred in Western countries, the majority of the participants in the trials have been men, reflecting the nature of the epidemic. It has therefore often been difficult to find accurate information on women-specific issues related to ART. We know that most positive people worry about the long-term impacts of HIV treatment and this concern can also be amplified for women when they are considering having children and worry about the effects of ART on their unborn babies.

Evidence now shows that treatments are equally effective for both men and women. However, it does seem that women may be more likely to experience some side-effects than men and this may be due to the fact that they women tend to be less heavy than men therefore they are proportionally receiving a higher dose of drug in terms of their body weight. Recent evidence appears to show that lipodystrophy (changes in body shape associated with fat distribution) in particular is more common in women than in men and the way this appears tends to be in accumulations on fat rather than fat loss.

It is important that a woman taking ART is regularly monitored by an HIV specialist and that she reports any side-effects she thinks may be related to her medication.