Miami Herald - Wednesday, December 28, 1994

Although the study could not pinpoint the reasons for the difference, the researchers believe they are related to socioeconomic factors, such as the ability of women to get to see doctors and pay for medications. Biological differences are not considered a factor.

The men studied were mostly gay and white and better informed than were their female counterparts about the disease, researchers said. They had better access to treatment and took better care of themselves.

The women were more likely to be black or Hispanic and to have a history of intravenous drug use, said Sandra Melnick, a epidemiologist and lead author of the study while she was with the University of Minnesota.

"We hope that some people with really good ideas will seize on this and take it to the next step," she said.

The study, which is published in today's issue of the Journal of the American Medical Association, highlights a gap in treatment for women, who have become particularly vulnerable to the disease.

When AIDS first hit the world scene, it was primarily a disease of men. In recent years, an increasing number of women have been developing the immune system disorder, especially in urban centers where drug use is rampant.

According to the Centers for Disease Control and Prevention in Atlanta, 51,235 women have AIDS, which represents more than a 20-fold increase since 1981 and accounts for nearly 13 percent of all U.S. cases.

Not only will doctors be faced with treating more HIV-infected women, they also will be following treatment recommendations based largely on observations of how the disease progresses among men, the study said.

In the study, researchers followed the medical records of 768 women and 3,779 men who were enrolled in 11 AIDS-treatment protocols at 17 community-based centers around the nation ( none in Florida).

During that period, the researchers found that women were 30 percent more likely than men to die suddenly and apparently without first developing infections and cancers commonly associated with the disease.

Many HIV patients die outside hospital settings, so information on causes of death is difficult to obtain, the researchers said.

"Some of (those deaths) may have been from AIDS-related disease, but there may have been other causes as well, such as violence, motor vehicle deaths and drug overdoses," Melnick said.

Researchers did not find any difference in disease progression rates, which means that there appear to be no biological reasons why women should not respond as well as men to various AIDS medications, Melnick said.

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