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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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Presentation Transcript
2007 world aids day report
2007 World AIDS Day Report
  • http://youtu.be/P2156xyIIXM
background
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

summary of articles
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

risk factors for hiv infection among women in carletonville south africa
“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

gender based violence risk of hiv infection in women in south africa
“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

influence of infant feeding patterns on transmission of hiv 1 in durban
“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

overview hiv in pregnancy
Overview: HIV in Pregnancy
  • HIV in Pregnancy
    • Susceptibility
    • Interactions of HIV and pregnancy
    • Mother-to-child transmission
  • Management of HIV+ Pregnancies
susceptibility why are women likely to be infected
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

interactions
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

mother to child vertical transmission
Mother-to-child vertical transmission
  • 15-20% US/Europe, 25-40% Africa/Asia
  • Effectiveness of ART intervention

McIntyre, HIV in Pregnancy, 1998

management of hiv pregnancy
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