Acquired Immunodeficiency Syndrome (AIDS) was primarily diagnosed in men in the early 1980s, but the disease has since become more prevalent among women. In 1988, AIDS cases reported among men were 7,504 compared to 524 among women. By 2003, the number of cases reported among women had grown to 11,561, an increase of over 2,000 percent. In 1993, the Centers for Disease Control and Prevention expanded the criteria for AIDS cases to include persons with severe immunosuppression, pulmonary tuberculosis, recurrent pneumonia, and invasive cervical cancer.1 This change is partially responsible for the greatly increased number of reported AIDS cases.

Although the number of AIDS cases has increased among women in general, the epidemic has disproportionately affected particular racial and ethnic groups. In 2003, non-Hispanic Black and Hispanic women represented less than one-fourth of all U.S. women, yet they accounted for more than three-fourths of women with AIDS. In 2002, HIV/AIDS represented the 5th leading cause of death among women aged 35-44, but it was the 3rd leading cause among non-Hispanic Black women in this age group and the leading cause among non-Hispanic Black women aged 25-34.2

Of the 11,561 reported AIDS cases among women in 2003, 45 percent were infected through heterosexual contact. Among these women, 76 percent were exposed through sex with an HIV-infected person without a specified risk, 18.8 percent were exposed through sex with an injection drug user, and 4.3 percent were exposed through sex with a bisexual male. Of all reported cases among women in 2003, another 19.5 percent were infected through their own injection drug use. One percent of women were infected by receipt of blood components or tissue, and less than one percent were exposed due to hemophilia or another coagulation disorder. An additional 34 percent of women were exposed through a risk that was not reported or identified.

Overall, between 1998 and 2003 the number of women dying with AIDS and the number of new diagnoses increased only slightly. The number of reported cases is potentially misleading since it does not indicate when a person was infected. In contrast, the number of women living with AIDS rose dramatically (from 57,338 to 88,815) between 1998 and 2003, due in large part to recent advances in combination drug therapies.

Graph: AIDS Cases by Selected Exposure Categories for Females at Diagnosis[d]

Graph: Female AIDS Cases by Exposure Category and Race/Ethnicity[d]

Graph: Estimated Number of Diagnoses of AIDS, Women Living with AIDS, and Deaths Among Women with AIDS[d]

1 Centers for Disease Control and Prevention. Impact of the Expanded AIDS Surveillance Case Definition on AIDS Case Reporting-United States, First Quarter, 1993. MMWR 42(16):308-310.

2 Anderson RN, Smith BL. Deaths: Leading Causes for 2002. National Vital Statistics Report 2005; 53(17).