40% of new infections in women...

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40% of new infections globally are now occuring in women, according to

American epidemiologist Prof. Kenrad Nelson. It is well known that the

gender disparity seen in the early days of the pandemic has disappeared, and



The cervix is the neck of the womb, at the top of the vagina. This tight ‘collar’ of tissue closes off the womb except during childbirth. Cancerous changes are most likely in the transformation zone where the vaginal epithelium (lining) and the lining of the womb meet.

human papilloma virus (HPV)

Some strains of this virus cause warts, including genital and anal warts. Other strains are responsible for cervical cancer, anal cancer and some cancers of the penis, vagina, vulva, urethra, tongue and tonsils.

herpes simplex virus (HSV)

A viral infection which may cause sores around the mouth or genitals.

pelvic inflammatory disease

An infection of the upper female genital tract affecting the uterus, fallopian tubes and ovaries, commonly caused by the bacteria responsible for the sexually transmitted infections including gonorrhoea and chlamydia. If left untreated, pelvic inflammatory disease can cause pain, tubal pregnancy and infertility. Severe cases may even spread to the liver and kidneys, causing internal bleeding and death. 


Chlamydia is a common sexually transmitted infection, caused by bacteria called Chlamydia trachomatis. Women can get chlamydia in the cervix, rectum, or throat. Men can get chlamydia in the urethra (inside the penis), rectum, or throat. Chlamydia is treated with antibiotics.

in some developing countries women now out-number men in the AIDS

statistics. Gender equality in HIV/AIDS cases also appears to be directly

linked to gender inequalty at a social, economic and sexual level.

In a panel discussion on the growing Asian HIV epidemic among women,

Professor Dr. Alaka Deshpande reviewed her clinical experience at the main

research hospital in Mumbai, India. Cases have risen dramatically – she was

seeing 9 female patients with HIV in 1991, and in the first half of 1999 has

seen over 300. The social background of these women has also shifted

substantially. In the early days the majority of her clients were women

working in the sex industry – now the vast majority are housewives.

Reviewing the history of 370 HIV-positive women reported in 1998, she

identified that 350 were infected by their husbands. 64% of these women are

aged 21-30, and 20% of them have already been widowed by AIDS. This is

consistent with data presented elsewhere in the Congress, for example

Newmann et al report that 88% of HIV-positive women in South India report a

history of only one lifetime sexual partner. Deshpande highlighted some of

the disturbing practices underpinning the epidemic in India, in particular

the continued practice of child marriage. Young girls have particular

physical vulnerabilities to HIV given that the immature reproductive tract

is easily traumatised by early sexual intercourse, increasing the risks of

HIV acquisition.

In addition to this Deshpande reported extremely high rates of STIs, with

88% of women showing up as experiencing Pelvic Inflammatory Disease, yet few

complainig of symptoms. Indeed, one of the critical compounding variables

for these STIs is the fact that they are asymptomatic. Work published by

Joshi (also from Mumbai) shows that, among 300 HIV-negative women, 55% had

bacterial vaginosis, 45% Trichmoniasis, 40% monilliasis, 27% chlamydia, 17%

herpes simplex virus and 15% Human papilloma virus. HPV is one of the prime

causes of cervical cancer, and this is as strongly associated with increased

rates of cervical pre-cancers among HIV-infected women in the Asian region

as has previously been extensively reported in Europe and the US.

Confronting HIV in women is complex, and Deshpande clearly identified how

most current models exhibit significant gender bias, for example

exhortations to practise monogamy are meaningless when most women are

infected in monogamous relationships. She defined an action agenda for women

thus: Reproductive Health services; Health Care at the doorstep, Early

Detection, Education, Social Support, Political Partnership, Empowerment.