High-Risk HIV Behaviors - Women in Utah

Utah

Human immunodeficiency virus (HIV) attacks the body’s immune system and, if left untreated, can progress to the most severe stage of HIV infection known as acquired immunodeficiency syndrome (AIDS). When AIDS occurs, a person’s immune system has been severely damaged, and they are more likely to develop infections and cancers. HIV is spread when certain bodily fluids of people with HIV who have a detectable viral load enter the bloodstream of someone without HIV. Common routes of HIV transmission in the United States include unprotected sex and sharing syringes and other injection equipment with someone who has HIV.

HIV presents unique challenges for women, including increased risk of cervical cancer and heart disease. Some HIV medicines can interact with hormonal birth control, making it less effective at preventing pregnancy. There is an additional risk of transmitting HIV through pregnancy, childbirth or breastfeeding, but that risk can be reduced to 1% or less with proper medical planning. 

People with HIV can also experience HIV-related stigma, which is negative attitudes or beliefs about people with HIV. HIV-related stigma can discourage people from getting tested and accessing services, and is associated with negative health outcomes such as depression.

HIV can infect anyone regardless of age, gender, sexual orientation or race/ethnicity. However, certain behaviors like unprotected sex and needle/syringe sharing put some groups at higher risk than others.

According to America’s Health Rankings analysis, the prevalence of engaging in high-risk HIV behaviors is higher among:

• Women ages 18-24 compared with women ages 25-44.
• Multiracial women compared with white, Hispanic and Asian women. 
• Women with an annual household income less than $50,000 compared with those who have incomes of $100,000 or more. 
• Women who have difficulty with cognition, difficulty with independent living, difficulty seeing, difficulty with self-care, difficulty hearing and difficulty with mobility compared with women who do not have a disability. 
• Lesbian, gay, bisexual and queer (LGBQ+) women compared with straight women.

There are steps people can take to lower their risk of being infected with HIV, including: 

• Abstaining from sex or having fewer sexual partners.
• Correctly using a male or female condom every time they engage in sexual activity.
• Taking medications such as pre-exposure prophylaxis (PrEP) or post-exposure prophylaxis (PEP) if they are at high risk of getting HIV through sex or injection drug use. 

Abstaining from injection drug use is a primary prevention strategy to avoid HIV infection from drug use, but if that is not possible, the risk of infection can be lowered by using only clean, sterile needles and not sharing needles with anyone. Many communities have started implementing syringe service programs, such as needle exchanges. These programs provide access to sterile needles, safe disposal of used syringes and connections to other resources, such as treatment programs for substance use disorder and treatment care for HIV. Studies have indicated that needle and syringe programs are effective at reducing new cases of HIV.

While there is no vaccine or cure for HIV or AIDS, medical therapies can help manage the symptoms. Those diagnosed with HIV should start taking medicine to treat it as soon as possible. The treatment for HIV, antiretroviral therapy (ART), can decrease the amount of HIV in the body so much that it becomes undetectable. At that point, the person has effectively no risk of transmitting HIV to someone who is HIV-negative through sex. 

The HIV.gov site provides resources and a tool to help people locate local HIV prevention services, including condoms, HIV testing, PrEP and PEP in their area. The Ryan White HIV/AIDS Program (RWHAP) is a federal program that provides support for low-income individuals living with HIV. 

Healthy People 2030 has several goals related to HIV, including reducing the number of new HIV infections and increasing knowledge of HIV status. 

Additionally, the U.S. Department of Health and Human Services is working on an initiative to reduce new HIV infections by 90% by 2030. 

Abdul-Quader, Abu S., Jonathan Feelemyer, Shilpa Modi, Ellen S. Stein, Alya Briceno, Salaam Semaan, Tara Horvath, Gail E. Kennedy, and Don C. Des Jarlais. “Effectiveness of Structural-Level Needle/Syringe Programs to Reduce HCV and HIV Infection Among People Who Inject Drugs: A Systematic Review.” AIDS and Behavior 17, no. 9 (November 2013): 2878–92. https://doi.org/10.1007/s10461-013-0593-y.

Rueda, Sergio, Sanjana Mitra, Shiyi Chen, David Gogolishvili, Jason Globerman, Lori Chambers, Mike Wilson, et al. “Examining the Associations Between HIV-Related Stigma and Health Outcomes in People Living With HIV/AIDS: A Series of Meta-Analyses.” BMJ Open 6, no. 7 (July 2016): e011453. https://doi.org/10.1136/bmjopen-2016-011453.