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Through December1994, the Centers for Disease Control and Prevention (CDC)
received reports of 38,428 cases of acquired immunodeficiency syndrome (AIDS)
among adult and adolescent (13 years and older) women in the United States.
The proportion of women among cases in adults and adolescents has increased
steadily, from 7 percent in1985 to18 percent in1994.
The 14,081 women reported with AIDS in 1994 represented nearly one-fourth
(24 percent) of the total number of AIDS cases ever reported among women.
Forty-one percent of women reported with AIDS in1994 acquired human immunodeficiency
virus (HIV) through injection drug use and 38 percent through heterosexual
contact with at-risk partners. The remaining 21 percent of these women received
contaminated blood or blood products (2 percent) or had no specific exposure
reported (19 percent).
Of the 5,353 women reported with AIDS in 1994 whose HIV infections were
attributed to heterosexual contact, 38 percent reported sexual contact with
a male injection drug user and 53 percent with a partner with HIV/AIDS whose
risk was not specified. The large proportion of women reported with AIDS
in 1994 with unreported risk will decrease after investigation by local/state
health departments. After follow-up, most women are found to have a recognized
risk for HIV infection. Heterosexual contact with an HIV-infected man is
the most rapidly increasing transmission category among women.
AIDS and other illnesses due to HIV infection have been the fourth leading
cause of death since 1992 among U.S. women between the ages of 25 and 44.
In this age group, the rank of HIV infection among causes of death for black
women advanced from second in 1992 to first in 1993, and for white women,
from sixth in 1992 to fifth in 1993. (Data for 1993 are provisional.)
Although black and Hispanic women make up 21 percent of all U.S. women,
more than three-fourths (77 percent) of AIDS cases reported among women
in1994 occurred among blacks and Hispanics. For adult and adolescent U.S.
women, the AlDS case rate per l00,000 population in l994 was 3.8 for non-Hispanic
whites; 62.7 for non-Hispanic blacks; 26.0 for Hispanics; 1.3 for Asian/Pacific
islanders; and 5.8 for American Indians/Alaska Natives. The AIDS rate for
black and Hispanic U.S. women was approximately l6 and 7 times greater, respectively,
than that for white U.S. women.
Data from the HIV Survey in Childbearing Women indicated that in 1993 an
estimated 7,000 HIV-infected women delivered infants in the United States.
Assuming a perinatal HIV transmission rate of 15 percent to 30 percent,
approximately 1,000-2,000 infected infants were born during 1993.
CDC provides prevention messages to women through community-based organizations
(CBOs), school-based programs, and public information and education programs.
Through health departments and CBOS, women at risk for HIV are reached
with interventions such as street outreach, risk-reduction counseling, and
prevention case management. CDC's programs include a number of activities
designed to educate women, and the public in general, about how HIV is
transmitted, who is at risk of acquiring the infection, and how the infection
can be prevented. These activities include a national media educational
campaign, the CDC National AIDS Hotline, and the CDC National AIDS Clearinghouse.
In collaboration with the National Institutes of Health (NIH), CDC initiated
the HIV Epidemiology Research Study at four U.S. sites to investigate the
natural history of HIV disease in women and to characterize risk factors
for conditions indicative of AIDS in women. CDC also awarded funds to an
additional four sites to develop, implement, and evaluate programs for
the prevention of HIV infection and AIDS among women and infants.
Also in collaboration with NIH, CDC is evaluating the effectiveness of the
female condom and assessing the determinants of its consistent and correct
use.
Several ongoing HIV evaluation studies are specifically directed to women
and are designed to:
Women are among the population groups expected to benefit from two CDC initiatives
that began in early 1994:
The HIV Prevention Community Planning Initiative represents a significant
step forward in the planning of culturally competent and scientifically
sound HIV prevention services that specifically address unique community
needs. Community planning is a process whereby the identification of high
priority prevention needs is shared between the health department administrating
HIV prevention funds and representatives of the communities for whom the
services are intended. In addition, the community planning process embraces
the notion that the behavioral and social sciences must play a critical
role in the development, implementation, and evaluation of HIV prevention
programs within a community.
The Prevention Marketing Initiative (PMI). CDC's PMI is a large-scale national
effort to change behaviors that contribute to the transmission of HIV and
other sexually transmitted diseases (STDs). lt represents a shift from previous
mass health communications programs, aimed at increasing general awareness
of HIV/AIDS, to influence behavior changes among people at high risk
for HIV infection or transmission. PMI is an application of marketing techniques
and consumer-oriented communications technologies based on science and directed,
in its first phase,
to the prevention of sexual transmission of HIV and other STDs among young
adults 18-23 years of age. To achieve the PMI behavioral objectives, CDC
will work simultaneously at the national, state, and local levels through
four components: (1) National Communications, (2) Prevention Collaborative
Partners, (3) Local Demonstration Sites, and (4) Application in HIV Prevention
Community Planning.
For more information:
CDC National AIDS Hotline:1-800-342-AIDS (2437)
Spanish: 1-800-344-SIDA (7432)
Deaf: 1-800-243-7889
CDC National AIDS Clearinghouse
P.O. Box 6003
Rockville, MD 20849-6003
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