Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2013 Oct 1;16(1):18509.
doi: 10.7448/IAS.16.1.18509.

Caring for women living with HIV: gaps in the evidence

Mona R Loutfy  1 , Lorraine Sherr, Ulrike Sonnenberg-Schwan, Sharon L Walmsley, Margaret Johnson, Antonella d'Arminio Monforte; Women for Positive Action
Affiliations
Review

Caring for women living with HIV: gaps in the evidence

Mona R Loutfy et al. J Int AIDS Soc. .

Abstract

Introduction: In the management of HIV, women and men generally undergo the same treatment pathway, with gender differences being given limited consideration. This is in spite of accumulating evidence that there are a number of potential differences between women and men which may affect response to treatment, pharmacokinetics, toxicities and coping. There are also notable psychological, behavioural, social and structural factors that may have a unique impact on women living with HIV (WLWH). Despite our increasing knowledge of HIV and advances in treatment, there are significant gaps in the data relating specifically to women. One of the factors contributing to this situation is the under-representation of women in all aspects of HIV clinical research. Furthermore, there are clinical issues unique to women, including gynaecologic and breast diseases, menopause-related factors, contraception and other topics related to women's and sexual health.

Methods: Using scoping review methodology, articles from the literature from 1980 to 2012 were identified using appropriate MeSH headings reflecting the clinical status of WLWH, particularly in the areas of clinical management, sexual health, emotional wellbeing and treatment access. Titles and abstracts were scanned to determine whether they were relevant to non-reproductive health in WLWH, and papers meeting inclusion criteria were reviewed.

Results: This review summarizes our current knowledge of the clinical status of WLWH, particularly in the areas of clinical management, sexual health, emotional wellbeing and treatment access. It suggests that there are a number of gender differences in disease and treatment outcomes, and distinct women-specific issues, such as menopause and co-morbidities, that pose significant challenges to the care of WLWH.

Conclusions: Based on a review of this evidence, outstanding questions and areas where further studies are required to determine gender differences in the efficacy and safety of treatment and other clinical and psychological issues specifically affecting WLWH have been identified. Well-controlled and adequately powered clinical studies are essential to help provide answers to these questions and to contribute to activities aimed at improving the health and wellbeing of WLWH.

Keywords: HIV; gender; pharmacokinetics; safety; stigma; women.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Meta-analysis of estimated differences in mean log10 HIV RNA levels between women and men [17].
Figure 2
Figure 2
Gender-related efficacy differences in women and men [21]. The publisher for this copyrighted material is Mary Ann Liebert, Inc. publishers.
See this image and copyright information in PMC

References

    1. Jensen SE, Pereira DB, Whitehead N, Buscher I, McCalla J, Andrasik M, et al. Cognitive-behavioral stress management and psychological well-being in HIV+ racial/ethnic minority women with human papillomavirus. Health Psychol. 2013;32(2):227–30. - PMC - PubMed
    1. Nicastri E, Leone S, Angeletti C, Palmisano L, Sarmati L, Chiesi A, et al. Sex issues in HIV-1-infected persons during highly active antiretroviral therapy: a systematic review. J Antimicrob Chemother. 2007;60(4):724–32. - PubMed
    1. d'Arminio Monforte A, Gonzalez L, Haberl A, Sherr L, Ssanyu-Sseruma W, Walmsley SL, et al. Better mind the gap: addressing the shortage of HIV-positive women in clinical trials. AIDS. 2010;24(8):1091–4. - PubMed
    1. Arksey H, O'Malley L. Scoping studies: towards a methodological framework. Int J Soc Res Methodol. 2005;8(1):19–32.
    1. Sayles JN, Wong MD, Kinsler JJ, Martins D, Cunningham WE. The association of stigma with self-reported access to medical care and antiretroviral therapy adherence in persons living with HIV/AIDS. J Gen Intern Med. 2009;24(10):1101–8. - PMC - PubMed

Substances

LinkOut - more resources