HIV and Specific Populations

Yes. According to the Centers for Disease Control and Prevention (CDC), in 2018, 19% of the new HIV diagnoses in the United States and dependent areas were among women. In addition, 57% of women with HIV were Black/African American.

The most common way that women get HIV is through sex with a male partner who has HIV without using a condom. Most women who have HIV know that they are HIV positive, but some women are not getting the HIV care and treatment they need.

HIV is spread through blood, pre-seminal fluids, semen, vaginal fluids, rectal fluids, and breast milk. In the United States, the main risk factors for HIV transmission are the following:

• Having anal or vaginal sex with a person who has HIV without using a condom or taking medicines to prevent or treat HIV. Anal sex is the riskiest type of sex for getting HIV, because the rectum’s lining is thin and may allow HIV to enter the body during anal sex.
• Sharing injection drug equipment (works), such as needles, with a person who has HIV.

In women, several factors can increase the risk of HIV transmission. For example, during vaginal or anal sex, a woman has a greater risk for getting HIV because, in general, receptive sex is riskier than insertive sex. Age-related thinning and dryness of the vagina may also increase the risk of HIV in older women, because these can cause a tear in the vagina during sex and lead to HIV transmission. A woman's risk of HIV can also increase if her partner engages in high-risk behaviors, such as injection drug use or having sex with other partners without using condoms.

Treatment with HIV medicines (called antiretroviral therapy or ART) is recommended for everyone with HIV. Treatment with HIV medicines helps people with HIV live longer, healthier lives. ART also reduces the risk of HIV transmission.

People should start taking HIV medicines as soon as possible after HIV is diagnosed. However, birth control and pregnancy are two issues that can affect HIV treatment in women.

Birth control

Some HIV medicines may reduce the effectiveness of hormonal contraceptives, such as birth control pills, patches, rings, or implants. Women taking certain HIV medicines may have to use an additional or different form of birth control. For more information, view the HIV and Birth Control infographic from HIVinfo.

Pregnancy

Women with HIV take HIV medicines during pregnancy and childbirth to reduce the risk of perinatal transmission of HIV and to protect their own health.

The choice of an HIV treatment regimen to use during pregnancy depends on several factors, including a woman’s current or past use of HIV medicines, other medical conditions she may have, and the results of drug-resistance testing. In general, pregnant women with HIV can use the same HIV treatment regimens recommended for non-pregnant adults—unless the risk of any known side effects to a pregnant woman or her baby outweighs the benefits of a regimen.

Sometimes a woman’s HIV treatment regimen may change during pregnancy. Women and their health care providers should discuss whether any changes need to be made to an HIV treatment regimen during pregnancy.

From CDC:

• HIV and Women
• HIV Transmission
• Ways HIV can be Transmitted

From the Department of Health and Human Services:

• Guidelines for the Use of Antiretroviral Agents in Adults and Adolescents with HIV:
  • HIV and the Older Person
  • Women with HIV
• Recommendations for the Use of Antiretroviral Drugs During Pregnancy and Interventions to Reduce Perinatal HIV Transmission in the United States:
  • General Principles Regarding Use of Antiretroviral Drugs During Pregnancy: Overview
  • Recommendations for Use of Antiretroviral Drugs During Pregnancy: Overview

Also see the HIV Source collection of HIV links and resources.