HIV: Protecting the Health of All Women

Content From: Rochelle P. Walensky MD, MPH, Director, Centers for Disease Control and Prevention, and Administrator, Agency for Toxic Substances and Disease RegistryPublished: March 30, 20223 min read

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Dr. Rochelle P. Walensky

In this country and across the world, women have a long and valued history of protecting the health of their families and their communities. These efforts cross myriad roles and many settings – from the home to the community, from the health clinic to the hospital, and from schools to the legislatures. We owe an immense gratitude to women, from every walk of life, who support the health and wellbeing of so many around them. We also owe them our continued commitment to protect and improve their own health and wellness.

Though we have made tremendous progress in protecting the health of women and girls from HIV, they are still significantly impacted and continue to face challenges and barriers in accessing care, and disparities in outcomes. In 2019, cisgender women accounted for 18% (6,400) of estimated new HIV infections in the United States. These numbers broken down by race/ethnicity show that major racial disparities continue to exist, with Black or African American women making up more than half of the estimated new HIV infections among all women in 2019 (53%). Among transgender women interviewed in seven U.S. cities in 2019-2020, 42% reported having HIV, with Black transgender women having the highest prevalence of HIV followed by Hispanic/Latina transgender women with the next highest prevalence (62% and 35%, respectively).

The good news is that nine out of 10 women with HIV knew their HIV status in 2019. Among transgender women, data showed that 96% of transgender women had ever tested for HIV. These data are promising, indicating that women are getting tested for HIV and knowledge of HIV status is increasing. Knowledge of status is the first step to staying healthy and engaging in HIV prevention and care, regardless of a person’s HIV status. 

Women with HIV need to be linked to care and supported to stay once engaged. Accessing HIV treatment (i.e., antiretroviral therapy [ART]) and comprehensive care services will support women to achieve viral suppression, ensure optimal health, prevent HIV transmission, and reduce the chance of transmission to a baby during pregnancy and childbirth.

For women without HIV, there are many prevention tools --including condoms, post-exposure prophylaxis (PEP), and pre-exposure prophylaxis (PrEP) -- which are proven to decrease the risk of acquiring HIV. These powerful tools are underutilized by women. In 2019, only 35% of heterosexually active women without HIV surveyed in 23 U.S. cities were aware of PrEP. Furthermore, only 10% of women in the United States who could benefit from PrEP were prescribed the medication.

For transgender women, where HIV risk and prevalence are higher, the numbers are even more striking. Ninety-two percent of transgender women without HIV were aware of PrEP, yet only 32% used PrEP, according to data from the National HIV Behavioral Surveillance System. CDC’s recently updated PrEP guideline for health care providers states that all sexually active people should be informed about the availability and benefits of PrEP; it is an important tool for HIV prevention, including for people who may be at risk because of injection drug use. CDC’s updated guidelines help inform health care providers and support more conversations about PrEP in all health care settings.

We can end HIV in this country. To achieve this success, we must ensure that all women are aware of HIV testing, prevention, and treatment services and can easily access them. During Women’s History Month, on Women and Girls HIV/AIDS Awareness Day, and every single day, CDC reaffirms its commitment to women’s health through its ongoing work to overcome disparities, promote and support access to care for all women, and increase availability and accessibility to HIV prevention and treatment tools. Together, we can empower all women with the hope and healing to protect their own health, to empower women in the service of others, and to end HIV in the United States.