from the Morbidity and Mortality Weekly Report. Nov. 30 1990:

"....AIDS cases in women account for an increasing proportion of all AIDS cases in the United States. By the end of 1990, reports to Center for Disease Control of AIDS cases among women will exceed 15,000. From Nov. 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.

"HIV infection disproportionately affects women in racial/ethnic minority groups. Although black and Hispanic women constitute 19% of all US women, they represent 72% of all US women diagnosed with AIDS. In 1988, the death rate from HIV infection was nine times higher for black than for white women. These disproportionate rates largely reflect the occurence of HIV infection among injecting drug users and their sex partners.

"....Among all cases of AIDS in women, 88% occurred among women of child bearing 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.

"Editorial note: many women in the US are unaware that they are at risk for HV infection,....(they) often remain undiagnoses until the onset of AIDS or until a perinatally infected child becomes ill."

Comment: women with AIDS get sick differently from men. They almost never get Kaposi`s sarcoma, for example. They often present with very bad vaginal infections and pelvic inflammatory disease. HIV infected women also have a lot of abnormal Pap smears. The presence of cervical dysplasia was 8-11 times higher in HIV infected women, according to two studies in the same issue of MMWR. Cervix dysplasia may be related to viral infection, which of course might be more severe in HIV-infected women; or there might be other explanations, such as number of sex partners, smoking cigarettes, etc. in those populations.

Any women of colour on the echo?

Incidentally, the incidence of AIDS in Canada has fallen this year.

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