The Impact of HIV on Heterosexual Women

I remember seeing occasional information about HIV while growing up. This information was always presented with men, mainly men that identified as gay. Looking back on it today, everything I encountered made it seem more of an issue for individuals who used injection drugs, were extremely sexually active, and/or gay men.

From my perspective, the information was never presented in a way that should be concerning for heterosexual women. Even at this point in modern society, there is a representation bias. Despite this, there are finally ads for HIV antiretroviral medications that depict women using them and telling a snippet of their life. It is a slow start for shining light on the impact of HIV also on heterosexual women.

HIV in the US

According to the Centers for Disease Control and Prevention (CDC), women made up 19 percent of the 37,968 new HIV diagnoses in the US and dependent areas in 2018. While that percentage is low, there is a sharp distinction in how this population acquires the virus. The CDC shows that 85 percent acquired the virus through heterosexual contact.²

Race/ethnicity

For 2018, the ethnic breakdown of newly diagnosed women included:²

• 57% Black / African American,
• 21% White,
• 18% Hispanic / Latino.

The CDC tracked the new diagnosis trends among ethnicity between 2014 and 2018. During this timeframe, the new diagnosis rate among Black/ African American women and Hispanic/ Latino women decreased by 10 percent and 9 percent respectively. Considering these ethnicities are the most affected groups, this is a good thing. On the other hand, the diagnosis rate has increased 15 percent among white women during this timeframe. ²

Risks factors

There are various risk factors that affect heterosexual women more than heterosexual men. One of these risks involves the type of sex that individuals are participating in with their partner.²

This is because “receptive sex is riskier than insertive sex,” which “means that women are more likely to get HIV during vaginal or anal sex” than the men involved. Women may also be unaware of their partner’s risk factors, such as sleeping with other men or injection drug usage. ²

PrEP bias

PrEP, or pre-exposure prophylaxis, is a prescription drug that helps to prevent HIV-negative individuals from acquiring HIV. While PrEP is available for both men and women, there is a massive disproportion in how it is prescribed. Only "4.7 percent of PrEP users in the U.S." were women in 2016.⁴

Intimate partner violence

Intimate partner violence, referred to as IPV, has been connected to HIV diagnoses. IPV "includes physical violence, sexual violence, threats of physical or sexual violence, stalking and psychological aggression (including coercive tactics) by a current or former intimate partner." ⁴

The women in these situations may face several increased risk factors. These women may find themselves forced to have sex without a condom or other preventative measures or they may choose to engage in other risky sexual behaviors. It is unclear if being HIV-positive causes women to be in relationships with IPV or if these relationships cause women to become positive at a higher frequency.²

Women with HIV experience IPV at higher rates than the general population. Studies have shown that HIV-positive women experienced IPV at double the national rate and these women had a history of childhood sexual abuse and childhood physical abuse at double the national rates.⁴

HIV can impact anyone

HIV is an equal opportunity virus when it comes to genders. A continued effort is needed to ensure society is able to understand that everybody is at risk, including heterosexual couples. Women can benefit from an increase of PrEP prescribing and outreach efforts for IPV situations.