A Johns Hopkins physician and scientist who has spent a quarter-century leading major efforts to combat HIV and AIDS worldwide has issued an urgent call for global strategies and resources to confront the rapid "feminization" of the AIDS pandemic.
In an article appearing in the journal Science online June 10, Thomas C. Quinn, M.D., professor of infectious diseases at Hopkins and a senior investigator at the National Institute of Allergy and Infectious Disease, reports that women have in the last 20 years moved from those least affected by HIV to those in whom the disease is spreading fastest. "There has been a shift in the AIDS pandemic, and the victims are different now," says Quinn, senior author of the Science article.
"Women make up nearly half of the 40 million people worldwide currently infected with HIV, the virus that causes AIDS, and in some developing countries, women represent the vast majority of those living with HIV/AIDS," Quinn writes, whereas, at the start of the pandemic in the early 1980s, men accounted for almost 90 percent of cases in developed countries. In the United States from 1999 to 2003, the yearly increase in AIDS cases rose by 15 percent, but only by 1 percent in men.
"HIV/AIDS first targeted gay men and hemophiliacs in the early 1980s, then subsequently spread most quickly among intravenous drug users and heterosexuals," he adds. "Now, it is having the most profound impact on women."
Internationally, Quinn and his team have led clinical trials of the first effective treatments that prevent HIV from replicating, helped establish laboratory and treatment facilities in the Democratic Republic of the Congo, India and Uganda, and counseled other governments across Africa and Asia about control efforts.
In the new article, he argues that women deserve a separate strategy because of the increasing and disproportionate numbers becoming infected, and the social consequences of so many young mothers dying and leaving behind children who may also be infected as well as orphaned. He also points out that medical research suggests hormonal and developmental factors place young women at greater risk than men for contracting the virus when exposed to it.
In sub-Saharan Africa, 60 percent of people living with HIV are female, Quinn says, and in South Africa, Zambia and Zimbabwe, young women ages 15 to 24 are three to six times more likely to be infected than men. Women make up half the adult population living with the virus in the Caribbean and one-third of those in Latin America.