Women Living with HIV Does Sex and Gender Matter? A Current Literature Review.

BACKGROUND: As women are more susceptible to heterosexual HIV infection than men, it is predicted that the percentage of women amongst people living with HIV will continue to grow worldwide. This has not only impact on preventive and reproductive issues, but also on treatment of women with HIV. -

METHODS: Abstracts from the 9 superset th Conference on Retroviruses and Opportunistic Infections in Seattle and the XIV World AIDS Conference in Barcelona in 2002 have been reviewed for this article, complemented by further internet-search. -

RESULTS: Increased time was dedicated to sex and gender aspects in major conferences. Sex-mediated differences in viral replication tend to disappear within the first five to six years of HIV-infection. Providing adequate medical care, women do respond equally well or even better to antiretroviral treatment and do not progress faster than men to AIDS. Gaps in our knowledge on efficacy, side effects, and pharmacocinetics of antiretrovirals and psychosocial factors promoting adherence to treatment in women have been identified. -

CONCLUSIONS: If women die faster of AIDS, it is a matter of gender, but not sex. Providing access to treatment, psychosocial and behavioural aspects of adherence are mediated as a function of gender. Missing data on side effects and pharmacokinetic profiles of various treatments in women may be explained by the lack of regulatory requirements for statistically meaningful participation of women and sex-specific analysis as licensing criteria for drug approval. Involvement of women s community advisory boards (CABs) in the design of future studies may help to gather knowledge for recommendations in the treatment of women living with HIV.