Women and HIV/AIDS

Historically, women have often been excluded from HIV and AIDS advocacy, treatment, and research. At the start of the AIDS epidemic in 1981, medical and scientific communities did not recognize women as a group for research. Women were excluded from clinical trials of medication and preventative measures. They were also often blocked from being subjects in clinical research with exclusionary with restrictions like "no pregnant or non-pregnant women".[3] The National Institutes of Health (NIH) rejected grants that were targeted at understanding HIV in low-income women of ethnic minorities.[3] This lack of attention is often attributed to the prominence of the gay rights movement in the area of HIV and AIDS. HIV's clinical symptoms differ between men and women, and the focus on male symptoms caused medical professionals to overlook symptoms in women.

The first case of HIV in a woman in the US was reported in 1981.[1] In December 1982, the first cases of mother-to-child HIV transmission were recorded. The number of children infected with the virus increased throughout the decade. Zidovudine (ZDV), alternatively named azidothymidine (AZT), was introduced as a drug to treat HIV in the late 1980s, reducing the chance of mother-to-child transmission by up to 70%.[4][5]

As of 2019, women account for about 20% of reported HIV cases.[2] The two major modes of transmission to women are heterosexual sexual intercourse and intravenous drug use.[2]

Factors that increase the likelihood of HIV in women include lack of access to high-quality healthcare, injecting drugs, being a sex worker, and low income. Due to shame, many women who have been diagnosed to have HIV or AIDS do not report the matter to others or seek proper treatment.

1982

• The Centers for Disease Control and Prevention (CDC) declared "prostitutes" a risk category of contracting HIV.[6]
• Female (as well as male) drug users were observed to contract the disease.[6][7]

1983

• The NIH began to hire female nurses such as Barbara Fabian Baird to research AIDS.[6][8]
• The Women's AIDS Network was established.[6][9]
• The CDC added "female sexual partners of males with AIDS" as a risk category.[10][11][12]

1984

• Social worker Caitlyn Ryan became the first executive director of AID Atlanta, the oldest AIDS service organization in the Southwestern US.[13]

1985

• The San Francisco AIDS Foundation produced its first brochure about women and AIDS.[6][14]
• The San Francisco General Hospital, for the first time, admitted a woman to the AIDS ward (Ward 5B).[6]

1986

• Women represented 7% of cases of AIDS in the US.[6][15]
• The first book about AIDS policy, AIDS: A Public Health Challenge, was co-authored by Caitlyn Ryan. It served as a guide to many public officials.[6][16]
• Marie St. Cyr became the first director of the New York-based Women and AIDS Resource Network (WARN).[6][17]

1987

• The NIH allocated 13.5% of its total budget to women's health issues.[6]
• At the time, women were excluded from HIV trials unless they used birth control. No specifically AIDS- or HIV-related medical assistance or gynecological (relating to the female reproductive system and the breasts) care was provided.[3][6]
• The Food and Drug Administration (FDA) approved ZDV (AZT) as the first antiretroviral drug to treat AIDS.[15][18]

1988

• An article in the magazine Cosmopolitan incorrectly stated that women are able to have sexual intercourse with HIV-positive men without risk of contracting HIV if they have "healthy vaginas".[19]
• The Joint United Nations Programme on HIV/AIDS (UNAIDS) reported that the number of women infected with HIV in sub-Saharan Africa exceeded that of men.[4]

1990

• The First National Women and HIV Conference was held in Washington, DC.[4][6]
• The [John H. Stroger Jr. Hospital of Cook County]] in Chicago, the only hospital in the city with an AIDS ward at the time, refused to admit women. Demonstrators set up a ward in a street in protest, and 35 protestors were arrested. Women were admitted to the ward two days after the protest.[6]
• The Women's Caucus of the AIDS Coalition to Unleash Power (ACT UP) wrote Women, AIDS, and activism.[4]
• On May 21, ACT UP members protested for the NIH to include women and people of color in HIV trials and treatment research.[5]

1992

• The CDC expanded the definition of HIV to include symptoms experienced by people of color and women in HIV trials and treatment recurrent pneumonia, pulmonary tuberculosis, stage III cervical cancer and recurrent vaginal candidiasis (yeast infections)[6][20]
• The International Community of Women Living with HIV/AIDS (ICW) was founded.[4]

1993

• The US Congress enacted the NIH Revitalization Act, giving the Office of AIDS Research (OAR) primary oversight of all AIDS research in the NIH. The act required all agencies to include women and ethnic minorities in research.[4][5]
• Gena Corea's book, The Story of Women and AIDS: The Invisible Epidemic, was published.[6]
• HIV became the leading cause of death for African-American women aged 25–44.[20]

1994

• On August 5, the US Public Health Service recommended that HIV-positive women take ZDV (AZT) to reduce the chance for perinatal transmission (infection through birth) of HIV, citing an ACTG 076 study that concluded that the drug reduces transmission by up to 70%.[4][5][6]
• The US Department of Health and Human Services issued orders that all grants that requested funding from the NIH must address and include the "appropriate inclusion of women and minorities in clinical research".[4][5]

1996

• The annual number of new AIDS cases in the US declined because of antiretroviral therapies.[6]

1997

• Women accounted for more than half of all cases of HIV globally.[6]
• In the US, 75% of diagnosed HIV cases were in African-American women.[6]