A study of sex differences in presentation for care of HIV

The current study examines sex differences in 183 male and 141 female patie nts presenting for care of HIV disease at an inner city hospital infectious disease clinic. Females (43%) were found to be less likely to have a histo ry of illicit drug use (relative risk = .77, p < .01) and more likely to ha ve become infected heterosexually (relative risk = 2.38, p < .01). However, a significant number of women reported both intravenous drug use (IVDU) an d heterosexual exposure to an IVDU partner which complicates the analysis o f the risk factors. Women sought testing because they knew that their sexua l partners were HIV-positive (relative risk = 2.88, p < .01) Median CD4 cou nts at entry were significantly different (females = 340, males = 246; p < .01). Women were less likely to contract tuberculosis, the only infection w hich presented with a sex difference (relative risk = .38, p < .01) and to have previously had an AIDS defining infection (relative risk = .37, p < .0 1). Women took longer to progress to AIDS (42 vs. 19 months; p < .05). Surv ival of patients with AIDS was 51 months for females and 54 for males (p > 0.9). It did appear that the effect of a lower CD4 cell count on risk for d eath was magnified in patients who acquired their disease through heterosex ual transmission. Women presented with higher CD4 counts, were more aware o f their risk factors and fared better, with respect to progression to AIDS, than the men. The study underscored the impact of heterosexual transmissio n of the virus in women as well as the affect of this risk factor on diseas e progression. Hopefully, this information will initiate further studies on sex differences which will guide interventions and policy development.