Sexo y VIH: Diferencias de género frente a la infección
HIV Infection and Women
María José Míguez, M.D. Ph.D., Universidad de Miami, EEUU.
The spread of HIV infection among women can be attributed to certain biological aspects, as well as general sociocultural factors which place women in a particularly vulnerable position. For example, women have been shown to have a greater risk than men, of becoming infected during unprotected heterosexual intercourse with an HIV+ partner. Moreover, hormones may impact immune responses differentially and influence women’s susceptibility to infectious diseases.
In studies conducted during the pre-HAART era, our research group identified nutritional differences in HIV-1 infected men and women, and showed that women were more likely to exhibit micronutrient deficiencies that dramatically affect HIV disease progression and risk for mortality. In recent studies, others have demonstrated that overall nutritional status, which is generally poorer in women than men, is a strong predictor of three-year survival in HIV-infection.
Of major concern, lower viral load levels have been documented in women, throughout the course of disease, and need to be carefully considered during HIV treatment. Despite gender-related differences in viral burden, however, time to AIDS is similar for men and women, raising the question of when to start antiretroviral treatment in women.
Gender-related differences in antiretroviral treatment response also need to be considered, as well as the potential effect of oral contraceptives on the efficacy and toxicity of various antiretroviral drugs. These data emphasize the importance of gender differences in HIV infection treatment and care. Recognizing this distinction will enhance our approach to diagnosis as well as daily counseling and management of HIV-1 infected women and men.