Health: Aids in US is spreading faster among women than men

Researchers have discovered that Aids is spreading more quickly among women in the United States than among men and that sexual contact - not infected needles - is the leading cause. The new findings offer a gloomy counterpoint to recent happier news on the treatment of Aids. In New York, David Usborne takes a look.

In most of the developed world, at least, the enemy has been in retreat all year. Study after study have shown new success in the prescription of drug cocktails to tame the impact on patients of HIV, the virus that leads to Aids.

Last week, officials in Washington offered this: the Aids mortality rate in America fell 26 per cent between 1995 and 1996. Moreover, the disease lost its crown as the leading cause of death among 25 to 44-year-old Americans. Now it is number two, just behind accidents and a little ahead of cancer.

But this latest report, published in the Journal of the American Medical Association and completed by researchers at the Centers for Disease Control in Atlanta, stops the music: there is still no vaccination and more Americans, especially the poor and disadvantaged, are getting the virus.

Moreover, the report, which spans 1991 to the end of 1995, shows that the number of those infected is now climbing fastest among American women.

"There has been a lot of attention on the declining death rate; this is the rest of the story," said Daniel Zingale, who is director of the US advocacy group Aids Action.

The number of women diagnosed with Aids between 1991 and 1995 grew in the United States by 63 per cent compared with an increase of 12.8 per cent for men. By the end of 1995, there were 67,400 women diagnosed with the disease since the epidemic began. Of those, 11,500 were identified in 1995.

Even so, Aids, once dubbed the gay man's plague, is still more prevalent among men than women. In 1995, for instance, the cases of women infected with HIV remained only about 19 per cent of the total for the year.

Attracting particular concern, however, are the behavioural findings behind the statistics. The CDC suggests that while sharing of dirty needles was for a long time considered the principle source of HIV infection among women patients, since 1993 sex with infected men has become the main culprit.

By 1995, 52 per cent of Aids cases among women could be traced back to sex with infected men, up from 40 per cent in 1991. By comparison, about 53 per cent of the men who contracted HIV in 1993 did so through homosexual contact. That was sharply down from 63 per cent in 1991. The sexual contact dimension is especially important, the study says, among women under the age of 25. They are 21/2 times more likely to catch HIV from sexual contact than by exposure to dirty needles for drug injection.

"It's critical to reach young people before they reach the age of having sex and injecting drugs," urged Dr Pascale Wortley, the chief researcher on the study. "The key is, get them before they even start".

Among the more striking findings in the study was that many adolescent women were contracting the virus through sexual contact with men significantly older than themselves. Moreover, the greater the age-gap, the less likely it was that the woman, often in her teens, would insist on him using a condom.

Mr Zingale of Aids Action insists that this means that while education of young women is important, so too is education of the men that may sleep with them. "Condoms cost 40 cents. Aids drugs cost $40 a day and may or may not work," he pointed out.

Researchers also confirmed fears that Aids is spreading fastest in the American Deep South. They suggested that this was caused by an epidemic of cocaine use in the region as well as the predominance, especially among poorer groups, of syphillis.

While the figures in the study do not go beyond the end of 1995, officials have indicated that new statistics due out later this week will confirm the same trends.