What every woman and girl should know about HIV prevention and care While HIV has been on the decline in recent years thanks to advancements in antiretroviral therapy (ART), thousands of people in the U.S. continue to be diagnosed annually. As of 2022, about 1.2 million Americans are currently living with HIV, half of whom […] The post Women & HIV: Unique Health Risks, Symptoms &Treatment Options To Consider appeared first on All About Women.
What every woman and girl should know about HIV prevention and care
While HIV has been on the decline in recent years thanks to advancements in antiretroviral therapy (ART), thousands of people in the U.S. continue to be diagnosed annually. As of 2022, about 1.2 million Americans are currently living with HIV, half of whom are over the age of 50.
Although the number of people with HIV infections decreased by about 12% from 2018 to 2022, an estimated 31,800 new HIV infections were diagnosed in 2022 alone, according to the Centers for Disease Control and Prevention (CDC). The majority of new HIV infections occurred in men, with women accounting for only about 17% of new infections.
Also of note, almost half of all new infections occurred in Southern states, which include Alabama, Arkansas, Delaware, Florida, Georgia, Kentucky, Louisiana, Maryland, Mississippi, North Carolina, Oklahoma, South Carolina, Tennessee, Texas, Virginia, and West Virginia.
The reality is that while HIV impacts everyone, the challenges for women are unique. While treatment has come a long way and is enabling people with HIV to live longer, healthier lives, women often face specific health concerns that aren’t as commonly discussed.
How does HIV affect females differently?
From gynecological issues and increased cancer risks to complications with pregnancy, birth control, and menopause, HIV can affect many aspects of a woman’s life in ways that require special attention. Let’s take a look at some of the key ways HIV affects women differently than men.
Gynecological health concerns with HIV
Women with HIV are more likely to experience certain gynecological health issues, including:
- Vaginitis. Women with HIV are more likely to experience chronic bacterial vaginosis (BV) and yeast infections that are difficult to treat.
- Pelvic inflammatory disease (PID). Women with HIV are at higher risk of developing PID, a serious infection of the reproductive organs that can cause chronic pain, infertility, and complications during pregnancy. PID can be more difficult to treat and can progress more rapidly in women with weakened immune systems.
- Sexually transmitted diseases (STDs). Infections like genital herpes can be more severe and harder to treat in women with HIV.
- Menstrual cycle problems. Missed periods, heavier bleeding, and worsening PMS symptoms are more common among women with HIV.
Regular gynecological checkups are especially important for women with HIV to monitor and treat these conditions before they become more serious.
Higher risk of cervical cancer
Women with HIV have a higher risk of developing cervical cancer. Most cases of cervical cancer are linked to the human papillomavirus (HPV), which is more common in women with HIV and harder for them to fight off due to their weakened immune systems.
Because the HPV vaccine has been shown to be highly effective at preventing HPV and cervical cancer, the CDC recommends that all women up to age 26 get the vaccine. Women with HIV should also be sure to schedule regular cervical cancer screenings from their well woman provider.
Increased risk of heart disease
Women with HIV are up to 3 times more likely to have a heart attack than those without the virus, according to the American Heart Association. This increased risk is linked to a combination of HIV-related inflammation, certain medications, and other health factors.
- Chronic inflammation from HIV can damage blood vessels over time, contributing to heart disease.
- Some HIV medications can raise cholesterol levels, further increasing the risk.
- Menopause-related hormonal changes can also impact heart health, especially in aging women with HIV.
- Mental health factors like chronic stress and depression have been linked to a greater buildup of plaque in the arteries, heightening cardiovascular risks, according to a recent study.
Regular heart health checkups, a balanced diet, exercise, and managing conditions like high blood pressure and cholesterol can help lower these risks, so talk to your doctor if you have HIV and are concerned about your heart health.
Birth control and family planning with HIV
For women with HIV, family planning requires careful coordination with a well woman provider to ensure a healthy pregnancy and effective birth control. Whether you’re thinking about having children or preventing pregnancy, it’s important to understand how HIV and its treatment can impact your reproductive choices.
Planning for pregnancy
Women with HIV can have safe and healthy pregnancies, but medical guidance is essential to minimize the risk of transmission to your baby.
With proper treatment, the risk of passing HIV to a baby can be reduced to less than 1%. However, some HIV medications are not safe during pregnancy and may need to be adjusted.
You should also be aware that breastfeeding still carries a small risk of transmission even if a mother has an undetectable viral load, so formula is often the safest option.
Birth control considerations
Women with HIV can safely use most forms of birth control, but some HIV medications can interfere with hormonal contraceptives, reducing their effectiveness.
Hormonal contraceptives (e.g., pills and patches) may not work as well when taken with certain HIV medications, so long-acting reversible contraception (LARC), such as IUDs, may be a more reliable option for some women.
Barrier methods like condoms are strongly recommended to prevent both unintended pregnancy and the spread of HIV and other STDs in women with HIV.
Increased side effects with HIV medications
HIV treatment works effectively for both men and women, but some medications can cause different side effects in women, such as:
- Increased nausea and vomiting. Some HIV medications, like ritonavir (Norvir), may cause stronger gastrointestinal side effects in women.
- Pancreas-related complications. Women taking certain HIV drugs may be more prone to conditions like acute pancreatitis.
- Higher risk of osteoporosis. Some HIV treatments may contribute to faster bone loss in women, increasing the risk of fractures.
If you experience any of these side effects while taking HIV medication, speak with your doctor. They may be able to adjust your medication or prescribe additional treatments to help alleviate your symptoms.
Aging with HIV
Thanks to new highly effective HIV treatments, women with HIV are living longer, fuller lives—cheers to that! But growing older with HIV isn’t always a walk in the park; it brings some unique health hurdles.
For one, menopause might sneak up earlier, and you might experience more severe hot flashes. You’ve also got a higher chance of developing conditions like diabetes, high blood pressure, and arthritis as you age, so be sure to get regular checkups and be open with your doctor about any health problems or concerns you have.
Debunking the biggest misconceptions about women’s health and wellness.
FAQs about HIV in women
Can I still get HIV if my partner is undetectable?
If your partner has an undetectable viral load, your risk of getting HIV from them is effectively zero. This is because when someone with HIV takes their medication consistently and maintains an undetectable viral load (meaning the virus is so low it can’t be detected in standard blood tests), they cannot transmit HIV through sex.
Extensive research supports this. As reported by the National Institute of Allergy and Infectious Disease, 3 major multinational studies tracked approximately 3,000 male-female and male-male couples over several years. These couples in the study had sexual intercourse without condoms approximately 74,000 times, and not a single case of HIV transmission was reported when the HIV-positive partner had an undetectable viral load.
This means that if your partner consistently takes their HIV medication and stays undetectable, you cannot contract HIV from them through sex. However, regular testing is essential and the use of condoms is still encouraged to prevent other sexually transmitted infections (STIs).
How long does it take to show symptoms of HIV in a woman?
The time it takes for HIV symptoms to appear in women varies. Some may experience flu-like symptoms (fever, sore throat, fatigue, rash) within 2 to 4 weeks of exposure, while others may not notice signs for years.
After this acute stage, HIV can remain dormant for a long time without noticeable symptoms, though some women may develop chronic yeast infections, swollen lymph nodes, or irregular periods.
If left untreated, HIV weakens the immune system over several years, leading to AIDS, which causes severe infections, weight loss, and frequent illness. Because symptoms can be mistaken for other conditions, getting tested is the only way to know for sure if you have HIV.
How is HIV treated in women?
HIV is treated with antiretroviral therapy (ART), a combination of medications that help control the virus, prevent it from damaging the immune system, and reduce the risk of transmission. Women with HIV should begin ART as soon as possible after diagnosis and take their medications exactly as prescribed.
Key aspects of HIV treatment in women include:
- Choosing the right medication. Some HIV drugs may cause different side effects in women, such as nausea, weight gain, or increased risk of osteoporosis. A doctor will tailor treatment to minimize these effects.
- Managing reproductive health. Women with HIV should have regular gynecological checkups, as they are at higher risk for cervical cancer, pelvic inflammatory disease (PID), and menstrual irregularities.
- Pregnancy and breastfeeding considerations. Women planning a pregnancy should work with a doctor to adjust medications if necessary. With proper treatment, the risk of mother-to-child transmission can be reduced to less than 1%. Breastfeeding carries a small risk of transmission, so formula or donor breast milk is often recommended.
- Heart health and bone health monitoring. HIV increases the risk of heart disease and osteoporosis in women. Regular checkups, a healthy diet, and weight-bearing exercises can help manage these risks.
With consistent treatment, women with HIV can live long, healthy lives and even achieve an undetectable viral load, meaning they cannot transmit the virus to their partners through sex.
We’re proud to help women in Florida with HIV get the gynecological care they need
Managing HIV as a woman comes with unique challenges, especially when it comes to reproductive health, heart disease, and aging. Regular checkups with a knowledgeable health care provider can make all the difference in maintaining a healthy, active life.
If you have concerns about gynecological health, birth control, or family planning while living with HIV, All About Women in Gainesville, Florida, is here to help. Our compassionate team understands the specific needs of women and offers personalized care in a supportive environment.
Schedule an appointment today with one of our well women care providers at our Gainesville or Lake City location to get the expert guidance and care you deserve.
References
Centers for Disease Control and Prevention. (2024, April 22). Fast Facts: HIV in the United States. CDC.gov. https://www.cdc.gov/hiv/data-research/facts-stats/index.html
HIV.gov. (2018, December 19). Preventing Mother-to-Child Transmission of HIV. HIV.gov. https://www.hiv.gov/hiv-basics/hiv-prevention/reducing-mother-to-child-risk/preventing-mother-to-child-transmission-of-hiv
Levy, M. N., Anastos, K., Levine, S. R., Plankey, M., Castel, A. D., Sherry Davis Molock, Sen, S., Asch, F. M., Milam, J., Aouizerat, B. E., Weber, K. M., Golub, E. T., Kaplan, R. C., & Kassaye, S. (2020). Depression and Psychosocial Stress Are Associated With Subclinical Carotid Atherosclerosis Among Women Living With HIV. Journal of the American Heart Association, 9 (13). https://doi.org/10.1161/jaha.120.016425
National Institute of Allergy and Infectious Diseases. (2020, June 12). 10 Things to Know About HIV Suppression | NIH: National Institute of Allergy and Infectious Diseases. www.niaid.nih.gov. https://www.niaid.nih.gov/diseases-conditions/10-things-know-about-hiv-suppression
Persistent depression might increase heart disease risk for women with HIV. (2020, June 22). www.heart.org. https://www.heart.org/en/news/2020/06/22/persistent-depression-might-increase-heart-disease-risk-for-women-with-hiv
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