HIV-INFECTION IN WOMEN - AN ESCALATING HEALTH CONCERN

The proportion of women infected with the human immunodeficiency virus (HIV) continues to increase. Over one-half of women acquire the virus through heterosexual contact. The diagnoses that define the acquired immunodeficiency syndrome and the use of antiretroviral therapy are si milar in men and women, except in pregnancy. However, management decis ions differ significantly regarding contraceptive and gynecologic care . Besides abstinence, use of the latex condom continues to be the most effective way of preventing transmission of HIV. The management of hu man papillomavirus-associated disease, pelvic inflammatory disease and vaginal candidiasis is especially challenging in women with HIV infec tion. A positive status for the virus does not appear to affect pregna ncy outcome. Each year, up to 2,000 infants are born infected with HIV . Transmission can occur by transplacental or intrapartum spread or th rough breast milk. Since 1994, prophylaxis with zidovudine has been sh own to be an effective method of limiting transmission to infants. It is important to offer all pregnant women a test for HIV, with counseli ng provided both before and after the test, even if testing does not b ecome mandatory under the law.