Roanoke Times
Copyright (c) 1995, Landmark Communications, Inc.
DATE: WEDNESDAY, December 28, 1994 TAG: 9412280072
SECTION: NATIONAL/INTERNATIONAL PAGE: A6 EDITION: METRO
SOURCE: ASSOCIATEd PRESS
DATELINE: CHICAGO LENGTH: Medium
No medical reason for the difference was apparent, said the study's authors, led by Sandra L. Melnick, an epidemiologist at the University of Minnesota School of Public Health.
Instead, the researchers said, women may wait until they are sicker before seeking care or may be treated differently.
The study tracked 768 women and 3,779 men - all infected with the AIDS virus - for about 15 months and found that women were 33 percent more likely to die than men who were comparably ill when they were enrolled in the study.
Women still are a small minority of U.S. AIDS cases - about 15 percent - but they and children are the fastest growing group of people with AIDS, said one co-author of the study in today's issue of the Journal of the American Medical Association.
``We're still way behind in reaching women at risk nationally,'' said Dr. Renslow Sherer, director of the Cook County HIV Primary Care Center in Chicago. ``This study just shows the devastating impact of HIV in women.''
In women, twice as often as in men, death was the first sign that HIV was progressing, the researchers found. In men, the first signs of the infection's progress were much more likely to be bouts of pneumonia or fungal infections.
The study, conducted at primary health care centers in 13 U.S. cities, is the largest and longest to explore differences in HIV disease between men and women, Sherer said. It is also one of the most representative, with 50 percent of subjects black or Hispanic and 20 percent women, he said.
But the study's breadth came at the cost of detail, including information on homelessness and poverty - two important factors in life expectancy for people with HIV infections, Sherer said.
Also, he said, ``we know that there's a very high incidence of domestic violence in women with HIV - in some cases extremely high,'' and that may cause deaths, he said.
Causes of death in the study were unavailable or unknown for 46 percent of 105 women who died and 36 percent of 700 men who died. Because many HIV patients die outside hospitals, information on causes of death is difficult to obtain, the researchers said.
Dr. Alexandra Levine, chief of hematology at the University of Southern California School of Medicine and a researcher on HIV in women, said her own findings suggest nonmedical factors play a big role in how infected women fare.
``It is extremely common for a woman to say she wants an HIV test but was afraid to ask the doctor,'' Levine said in a telephone interview. ``When she does ask, he says, `No, you don't need one, you're a nice girl.' Then, she has to say, `No, I'm not a nice girl.'''
Or, a woman may come to the emergency room with pneumonia, and a doctor may not suspect it's related to HIV.
by CNB