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HIV and Women in South Africa

HIV and Women in South Africa. Julia Tasset. 2007 World AIDS Day Report. http:// youtu.be/P2156xyIIXM. Background. P revalence of HIV in South Africa (2005) 16.9% in women and 4.4% in men 13.3% in blacks, 0.6% in whites Mean number of sexual partners for women is 2.3

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HIV and Women in South Africa

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  1. HIV and Women in South Africa Julia Tasset

  2. 2007 World AIDS Day Report • http://youtu.be/P2156xyIIXM

  3. Background • Prevalence of HIV in South Africa (2005) • 16.9% in women and 4.4% in men • 13.3% in blacks, 0.6% in whites • Mean number of sexual partners for women is 2.3 • 52% reported use of contraceptives by women • Less HIV in higher SES women • More HIV in CSW Muula, Croatian Med J, 2008

  4. Summary of Articles • HIV in South African women • Overall risk factors for HIV Infection • Gender violence and HIV risk • Infant Feeding Patterns and HIV-1 Transmission • HIV and Pregnancy For citations, see individual slides

  5. “Risk Factors for HIV Infection among women in Carletonville, South Africa…” • Urban setting, 834 women, cross-sectional study • Found 37.1% prevalence • 46% in migrant women, 34.7% in non-migrant women • 50.9% in women age 26-35 • Prevalence increased with number of partners • Also associated: marital status, alcohol use, STIs Zuma, Intl J STD & AIDS, 2003

  6. “Gender-based violence…risk of HIV infection in women…in South Africa” • Cross sectional study, 1366 women, based at four health clinic for antenatal care, face to face interviews conducted, assessing sociodemographics , Sexual Relationship Power Scale, and risk behaviors • Postulate: Controlling men more likely to impose risky sexual behavior on partners Dunkle, Lancet, 2004

  7. “Influence of infant-feeding patterns on…transmission of HIV-1 in Durban…” • Three groups: breastfed, mixedfed, and formula fed (never breastfed) infants • “Exclusive breastfeeding carried a significantly lower risk of HIV-1 transmission than mixed feeding and a similar risk to no breastfeeding” Coutsoudis, Lancet, 1999

  8. Overview: HIV in Pregnancy • HIV in Pregnancy • Susceptibility • Interactions of HIV and pregnancy • Mother-to-child transmission • Management of HIV+ Pregnancies

  9. Susceptibility:Why are women likely to be infected? • Biological • Susceptible cells, inflammation/ulceration • Socio-cultural • Lack of control over health, cultural blame as vector, CSW, traditional sex practices, lack on male condom use, pressure to produce children, lack of access to female-controlled barrier methods McIntyre, HIV in Pregnancy, 1998

  10. Interactions: Pregnancy’simpact on HIV • Natural suppression of immune system during pregnancy HIV’simpact on pregnancy • Associated co-morbidities • Early, ectopic pregnancy • Infections McIntyre, HIV in Pregnancy, 1998

  11. Mother-to-child vertical transmission • 15-20% US/Europe, 25-40% Africa/Asia • Effectiveness of ART intervention McIntyre, HIV in Pregnancy, 1998

  12. McIntyre, HIV in Pregnancy, 1998

  13. Management of HIV+ Pregnancy • Termination of pregnancy • Behavioral interventions • Therapeutic interventions • Obstetric interventions • Modification of infant feeding practices • Other therapies under research McIntyre, HIV in Pregnancy, 1998

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