AEGiS-AP: Study: Women-with HIV succumb faster than men - Researchers find no medical reason for the disparity, but say women may wait longer to seek help.

Important note: Information in this article was accurate in 1994. The state of the art may have changed since the publication date.

Study: Women-with HIV succumb faster than men - Researchers find no medical reason for the disparity, but say women may wait longer to seek help.

The Associated Press, Wednesday, December 28, 1994
Brenda C. Coleman; The Associated Press

CHICAGO: Women infected with the- AIDS virus die faster than men with the infection, a large study found.

No medical reason for the difference was apparent, said the study's authors, led by Sandra L. Melnick, an epidemiologist at the University of Minnesota School of Public Health.

Instead, the researchers said, women may wait until they are sicker before seeking care, or may be treated differently.

The study tracked 768 women and 3,779 men - all infected with the human immunodeficiency virus for about 15 months and found that women were 33 percent more likely to die than men who were comparably ill when they were enrolled in the study.

Women are still a small minority of U.S. AIDS cases -- about 15 percent -- but they and children are the fastest-growing group of people with acquired immune deficiency syndrome, said one coauthor of the study in today's issue of The Journal of the American Medical Association.

"We're still way behind in reaching women at risk nationally," said Dr. Renslow Sherer, director of the Cook County HIV Primary Care Center in Chicago.

In women twice as often as in men, death was the first sign that HIV was progressing, the researchers found. In men, the first signs of the infection's progress were much more likely to be bouts of pneumonia or fungal infections.

That suggests women may wait longer to seek treatment or may receive different care.

The study, conducted at primary health-care centers in 13 U.S. cities, is the largest and longest to explore differences in HIV disease between men and women, Sherer said. It is also one of the most representative, with 50 percent of the subjects black or Hispanic and 20 percent women, he said.

But the study's breadth came at the cost of detail, including information on homelessness and poverty -- two important factors in life expectancy for people with HIV infections, Sherer said.

Also, he said, "we know that there's a very high incidence of domestic violence in women with HIV -- in some cases extremely high," and that may cause deaths, he said.

Causes of death in the study were unavailable or unknown for 46 percent of 105 women who died and 36 percent of 700 men who died. Since many HIV patients die outside hospitals, information on causes of death is difficult to obtain, the researchers said.

Dr. Alexandra Levine, chief of hematology at the University of Southern California School of Medicine and a researcher on HIV in women, said her own findings suggest nonmedical factors play a big role in how infected women fare.

"It is extremely common for a woman to say she wants an HIV test but (is) afraid to ask the doctor," Levine said. "When she does ask, he says, `No, you don't need one, you're a nice girl.' Then, she has to say, `No, I'm not a nice girl.' "

Copyright (c) 1994 - The Associated Press. Reproduced with Permission. Reproduction of this article (other than one copy for personal reference) must be cleared through the Permissions Desk, The Associated Press, 50 Rockefeller Plaza, New York, NY 10020.
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