Women and Infectious Diseases

mental, and demographic changes during the 20th century have affected the health of women. Many of the changes have benefited women's health, but some have had deleterious effects. Infectious diseases pose an especially formidable threat to women, claiming >15 million lives around the globe each year (1). For many infectious diseases, women are at higher risk and have a more severe course of illness than men for many reasons, including bio-logic differences, social inequities, and restrictive cultural norms. These are often the same factors responsible for the disproportionate disease incidence among vulnerable populations throughout the world. Efforts to recognize and reduce health disparities among women have particular relevance for global health. HIV and AIDS in Women In addition to hunger, lack of education, and environmental and sociocultural constraints, HIV/AIDS and malaria, along with tuberculosis, continue to disproportionately affect and further weaken the condition of women in many of the world's poorest regions. Recent estimates indicate that more than half of the estimated 38 million cases of adult HIV infection worldwide are in women (2). Moreover, the social, economic, and psycho-logic effects of the disease are more severe for women. When their partners or fathers die, women often lose economic rights. A Ugandan survey found that one in four widows reported losing their property after their partner died (3). In sub-Saharan Africa, the region most affected by HIV, women are 30% more likely than men to be HIV-infected (2). The largest gender difference occurs among younger age groups. New HIV infections among women are also on the rise in the United States. An analysis of newly diagnosed HIV infections that occurred in 29 states from 1999 to 2002 showed that more than one third (35%) of cases resulted from heterosexual contact; among these heterosexually transmitted infections, almost two thirds (64%) occurred in women (4). Similarly, a recent analysis of New York City's HIV reporting data found that 35% of new HIV diagnoses in 2001 were in women, compared with 28% before 2001 (5). HIV infection in women has obvious implications for the health and well-being of children. HIV infection can be transmitted perinatally, and increasing numbers of chil-dren—estimated at ≈12 million—are orphaned by the disease (2). Although preventing HIV transmission from an infected mother to her infant has become feasible because of effective antiretroviral treatment regimens and has met with great success in many parts of the world, services that prevent …