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New HIV Patients Likely Women

Virginia- The typical HIV/AIDS patient was a once a young male who acquired the disease through sexual contact with another man. In many cases, he lived only weeks or months after diagnosis.

Today, the newly diagnosed HIV/AIDS patient is likely to be a woman who acquired the disease through heterosexual sex. With proper treatment, she will live for years.

The face of HIV/AIDS in the Fredericksburg area is changing, said Dr. Norman D. Bernstein, an infectious-disease specialist at Mary Washington Hospital.

The disease is now more of an equal-opportunity offender, Bernstein said.

And even though there is no cure, it is not as lethal as it once was. Patients who receive regular care and take their medications can think of themselves as having a chronic condition.

Bernstein offered this assessment on HIV/AIDS last week to the members of the Rappahannock Health Advisory Council, a citizen group that reviews new health projects for the state health commissioner.

Few doctors in the region treat as many HIV/AIDS patients as Bernstein and his colleagues, Dr. Paul A. Fiore and Dr. Anne Chiang, at Infectious Disease Associates. The practice has 135 patients, Bernstein said.

Some physicians may treat one or two patients, but most refer their clients to the infectious-disease specialists, said Nicole Smith-Binnix, executive director of Fredericksburg Area HIV/AIDS Support Services.

Using an overhead projector with slides and pie charts, Bernstein showed the council members how his patient population is changing.

For example, he said, the patients are getting older. Two-thirds are between 25 and 44, while a third are now over 45.

One reason, Bernstein said, is the use of up to 20 drugs that have been approved for the treatment of HIV/AIDS. This “cocktail” can be successful in controlling symptoms and prolonging life, he said.

Males are still more likely to get the disease, Bernstein added. But the number of women with HIV/AIDS is at 29 percent and growing.

“When I first started seeing HIV patients years ago, it used to be a ratio of 90 percent men, 10 percent female,” Bernstein said.

A similar shift is occurring across Virginia, said Wanda Cooper, spokeswoman for the Health Department’s Division of HIV/STD.

“Mostly what I’m seeing is an increase in African-American females,” added Smith-Binnix, FAHASS director.

No one is sure why the percentage of female patients is increasing. Women usually acquire the sexually transmitted disease from their husbands or boyfriends. Frequently, the man does not know he is infected.

Because of the increasing numbers of women, the typical way the disease is transmitted has changed.

Among Bernstein’s patients, 36 percent acquired the disease through heterosexual sex, while 31 percent acquired it through homosexual sex. Ten percent were infected while injecting drugs.

Statewide, men having sex with other men is still the primary means of transmission, according to Health Department figures.

HIV is a virus that attacks the body’s immune system. When the virus reduces the count of white blood cells below a certain level, the patient is said to have AIDS.

Patients acquire the disease through the blood, semen, vaginal fluids or breast milk of an infected person. Patients may be without symptoms for up to 10 years after being infected.

About 900 new AIDS cases and an equal number of new HIV cases are diagnosed in Virginia each year, according to the Health Department. The number of newly infected people has drifted downward for about a decade.

In the Fredericksburg region, 16 new HIV cases and 28 new AIDS cases were identified in 2002, according to the Health Department


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