Female biological vulnerability to HIV

AIDS is essentially a sexually transmitted disease (STD), which like some other such diseases can also be spread through blood and blood products, and from an infected woman to her unborn or newborn child. Women are biologically more vulnerable than men to HIV infection and other STDs. Studies in many countries have found that male-to-female transmission of HIV appears to be 24 times as efficient as female-to-male transmission. Postulated as the major factors responsible for differential transmission are the larger mucosal surface area exposed to virus in women and the greater viral inoculum present in semen compared with vaginal secretions. Male-to-female transmission of some STDs is at least 15% more efficient than female-to-male transmission. Young girls are particularly vulnerable. Their immature cervix and relatively low vaginal mucus production presents less of a barrier to HIV, making them biologically more vulnerable to infection than older premenopausal women.

Other data suggest that STDs especially those, such as chancroid and syphilis, which cause ulcerative lesions greatly facilitate both the acquisition and transmission of HIV. However, women with STDs are often asymptomatic and fail to recognize any infections. As a result, women are more vulnerable to HIV infection because they are more likely to have untreated STDs. Often their vulnerability to STDs is the result of their partners behaviour rather than their own. This increases the likelihood that they will not recognize low-grade infections. At the same time, women tend to avoid STD clinics for fear of being recognized and stigmatized. Women who do seek medical services often choose to go to primary health, family planning, and maternal and child health clinics for their care. Unfortunately, such facilities are often less well equipped to diagnose and treat STDs or may be unsympathetic or judgmental towards women with STDs.

Finally, women are disproportionately the recipients of blood transfusions and other blood products (e.g., for anaemia or childbirth complications). In the absence of adequate blood screening, womens vulnerability to blood-borne HIV transmission increases.