Cases of women being infected with HIV from sleeping with men on the rise

[somethingnewandexciting]

Does anyone know the cause of this? I heard it on Woman's Hour yesterday, am a couple of days behind, and couldn't figure out how it is possible for men's rates to drop and women's to increase at the same time.

The only thing I can think is that these are transwomen changing the health figures for women? The lady WH had on to discuss it didn't seem to know why either but as WH aren't exactly clear on gender data it could have been she didn't want to say it's transwomen? Surely Public Health resources spent advocating for women to be aware isn't going to actually make much of a difference if this is so...? Please someone tell me the NHS doesn't just lump transwomen in with women on campaigns we the public fund with tax?

So would you ban all hormonal contraceptives, all barrier contraceptives and abortion on the NHS? So everyone has to seek those things privately?

PreP has been a game changer in the treatment of HIV, it makes sense from a cost perspective approach, but I m also pretty sure that if it had affected women only, they would have been told to keep on using condoms.

Who would dare to deny a man his sacred right to sexual enjoyment without constraints, eh?

Except we have free contraception and free abortion that are medically useless to men, and have had them for a lot longer than Prep has been around.

So, presumably a fair number of women are having unprotected sex, and in the case of abortion aren't taking the free contraception either.

It's almost like most grown adults quite like sex (at least when they're younger), are biologically driven to do it, and don't always make the best decisions around it.

Yes but the argument is that we have those things because it benefits men to not have to worry about pregnancy.

I asked about banning all contraception and abortion because it is, in theory, another form of "state funded unprotected casual sex" in that allows people (but especially men) to minimise the risk of long term commitments and consequences from unprotected sex.

Jumping to TW is a bit of a reach as there's nothing Illogical about a rise in women's rates and a simultaneous drop in men - can you explain what doesn't make sense for you?

The more obvious explanation is wonen going to the doctor more quickly when there's an issue and routine testing in pregnancy. A women who feels off and finds out she has HIV takes steps to prevent infecting new partners. A man not going to the Dr in the same timeframe could be having sex with multiple women and infecting them.

I understand that. I just don't think that argument is correct. I don't think it's a coincidence that legal abortion and contraception came about after women received the right to vote and participate in politics. In fact, I think it's a case of direct causation.

If men had wanted legal, safe abortion available they could have had that about 100 years beforehand. They didn't, they came up with other mechanisms- illegal abortions, hiding pregnancies and handing the children to a relative, abandoning women they'd slept with, ensuring a huge pool of prostitutes who no-one cared about etc.

That is why I replied to the post actually, I find that brand of feminism- that only men want or enjoy sex or can decide they don't want a pregnancy right now very patronising. Even if all men 'behaved' and women had complete control of our sexualities in a shining matriarchal society, I'd quite like to keep abortion and contraception as options actually, and I don't believe I'd be alone in that view.

Yes of course they allow women control and freedom, too. I was asking if the other poster would ban those things on the NHS despite the fact they obviously benefit women as much as men.

You know, I've heard that they wouldn't even allow the trials for the pill today, as there are so many side effects.

Yes, I'm not trying to get into an argument with you. We were replying to different posters, and although our posts may appear similar in content, I do understand you might be coming from a different point of view/ reasoning.

I think the issue with side-effects from the pill is interesting. Medical ethics were much laxer back then. The question I'd ask is why nobody is trying to improve it or to develop better forms of female contraception? Some of that is undoubtedly patriarchal, but I personally doubt that gives the entire answer. Perhaps now women are talking about it rather than just putting up with it, some bright spark will spot an opportunity to make money and we'll get some traction towards something better.

Sorry this isn't new and has nothing whatsoever to do with TW.

The increase is because gay men were the focus of treatment and support once people understood HIV / Aids.

What nobody talks about is men who as far as most are aware are heterosexual and also on occassions having sex with men.

And these men may not act with the same responsibility as gay men.

And certainly dont think about women, if the woman they are partners with.

Just as women are left to take precautions against getting pregnant.

And why would you as woman think I need to check with my husband / partner if he has had unprotected sex.

Women are getting infected because men are irrresponsible.

https://committees.parliament.uk/committee/328/women-and-equalities-committee/news/210497/concerning-rise-in-hiv-diagnosis-rates-among-women-and-stretched-services-require-attention-in-hiv-action-plan-wec-says/

Different in some parts of Africa where precautions agains spreading HIV / Aids is not at the same level, and now worse thanks to Trumps cut in financial support for Aids projects, and the UK saying as from next year they wont be funding any programmes in other countries.

Have just found this group still exists. I thought it had lost funding and had closed.

They provide support and research to support women living with Aids.
https://sophiaforum.net/

I haven't read this, but a quick skim seems to show women dont feature much in this plan.
https://www.gov.uk/government/publications/hiv-action-plan-for-england-2025-to-2030/hiv-action-plan-for-england-2025-to-2030

And cant imagine it will tell men to behave responsibly and care enough about the women they have sex with not to infect them.

To a certain extent it’s a ‘how people talk about maths’ thing, and a what the starting point was.

When you look at the actual numbers. There are still more men being infected than women. But the gender difference is shrinking.

It’s not a ‘male’ specific disease. It’s comparative historical prevalence in men comes from unprotected anal sex being highest risk sexual activity for any kind of disease transmission, monogamy being less common in gay men at the time of HIV peaks compared to in heterosexual relationships, and condom use being comparatively lower (as no pregnancy considerations).

That combination lead to HIV transmission rates being very high prior to the public health campaigns taking effect. Result being more people is society who are infected and can therefore transmit. More opportunities to catch it.

Targeted Public health campaigns have been very effective at both reducing tranismission and increasing detection (which then further reduces transmission) in the gay male population. But straight men and women mainly assumed it didn’t apply to them. Transmission still occurs - and as more women and straight men have become infected, that transmission route slowly but surely results in more cases.

eg. Straight women on pill, has unprotected sex with man who is not aware has HIV. She doesn’t see him as being a risk because he gives a good chat on how has had std checks / doesn’t sleep around. She’s confident on contraception which is her primary concern. Gets infected unknowingly. No symptoms. Doesn’t realise. Repeats this with a handful of other straight men. None of this group have any risk awareness as dont think hiv applies to them. And other stds and pregnancy have symptoms. No symptoms - so think they’re fine.

Slowly but surely that transmission method gets around a new population, who aren’t risk aware. So women who earlier on very rarely got their ugly bits uncovered anywhere near someone with hiv, because it was almost exclusively a feature of the gay male community are now both getting it and transmitting it. From almost none to some is a big rate rise. Even if total count is still lower than men. Whereas gay men used to be high numbers. Awareness has brought that down. So rate is falling. Although falling rate from high start can still mean total is lower than women even if women’s rate is rising.

Impact of trans vs total population, negligible.

Impact of bisexuality, and individuals who had sex both with men and women - significant in enabling the disease to cross over between population groups. Impact of straight people assuming it’s a gay disease and thus not relevant to them. High.

eg. Ask yourself. Have you ever considered you might be an aysymptomatic carrier? And if not, why not. Same question on female friends who’ve been in long term marriages. Or recently divorced. . (No need to answer, but it’s enlightening).

Thank you all. I'm glad we are having the discussion anyway, as my initial response was wondering if transwomen were self reporting as female and skewing the numbers (how do we know what they go down as in the data - some clearly do say they are trans but they are notoriously keen to avoid any label, so we can only assume that number isn't the full figure). Obviously since then we've realised new incidence can be flagged with immigration and the general rise in STD and lowering of testing alongside stigma and awareness.

I do wonder how often young people go to GUM clinics these days? I used to be the annoying one of the friend group who dragged her hungover mates up in a group so we would be given the all clear if we'd had any dubious encounters. I always had the impression more women got STD checks than men, is that something we need to make more available again? I wish they'd create these Women's Health Hubs, we'd be saving millions of time off work for appointments if we could just get one done every visit alongside everything else, as well as informing and diminishing stigma.

According to this story they only started collecting data on men who pay for "sex" about 5 years ago!

HIV programmes and research have traditionally focused on female sex workers and less often on their male customers. This is partially redressed by a meta-analysis showing that 5% of men who purchase sex in low- and middle-income countries have HIV, a rate which is roughly double that of other men living in the same communities.

“These findings are further evidence that men who purchase sex should be designated as a key population in many countries, and that interventions to reduce HIV risk among these men should be prioritized,” write Dr Luh Putu Lila WulandariI of the University of New South Wales and colleagues in PLOS ONE.

In 2012, a systematic review and meta-analysis showed that female sex workers had 14 times higher HIV prevalence than women of a similar age in the general population. Last year, another review showed that laws criminalising sex work are associated with a sevenfold increase in the odds of HIV infection among female sex workers in sub-Saharan Africa.

However, the HIV prevalence in male customers across low- and middle-income countries had not been calculated until now. The investigators conducted a systematic review to identify studies which reported on the prevalence of HIV in men who purchased sex from women, as well as studies which reported on HIV prevalence among both customers and non-customers in the same study, or provided information which allowed calculation of the prevalence. The results were pooled in a meta-analysis.

https://www.aidsmap.com/news/sep-2020/increased-hiv-prevalence-men-who-buy-sex

Always be wary of the "lads trip to Thailand" 👀

A woman having sex 100 times with the same man. and having sex once with 100 men, the chances she gets pregnant are pretty much the same.

A man having unprotected sex 100 times with the same man or having sex once with 100 men, his chances of catching HIV differ by quite a lot.

There is a social aspect to it.

I still think that PreP is a great thing but it has been perceived by the most promiscuous within the gay community as a way to keep having reckless bareback sex with strangers.

That and the general misogyny of medicine that centres men and their expectations.

I work with a very mixed age group and the under 40s are not into safe sex at all. Surely this is why we are seeing an increase of all STDs, not just HIV, chlamydia and Gonorrhoea are apparently rife too.

The thing about HIV is that you have to have it to pass it on. That's why the analogy doesn't quite work. If you have unprotected sex with one man who has HIV one hundred times, your chances of getting HIV are pretty high. They are definitely much higher than 100 men who you made reasonable efforts to ensure their status is at least undetectable.

It isn't quite like conception where just the normal act of intercourse with no intervention can organically cause pregnancy.

I haven't RTFT, however increase of HIV in women can be due to vaginal atrophy in menopausal women. This means thinner weaker tissue more prone to micro tears which can make infection easier to take hold. Also increase in dating post divorce/ can't get pregnant so thinking condoms are not so important.
PrEP being offered to women or being taken up is tiny compared to gay men where I think numbers are dropping in comparison.

Having been at some WAD events last week it is recognised that this need to change with more awareness raised

https://www.bbc.co.uk/news/articles/cx2ew12zg75o

Sophia Forum is a brilliant charity - I've joined weekend workshops on menopause, bone health and more recently heart health (which women with HIV can be more impacted by) and learnt about advocacy in raising awareness and pushing for the rights of all women.

BTW it's living with HIV, not AIDS. AIDS is the name for a group of illness that untreated HIV might lead to. HIV is the name of the virus which, on (nowadays well tolerated) effective treatment, cannot be passed on to sexual partners

We actually say severe HIV not AIDS in the NHS. Especially when speaking to other professionals. Some might use the term to service users who use it themselves.

Interesting when it doesn't seem to be globally recognised, and this is a glocal disease:

while "AIDS" is still used as a specific clinical and surveillance definition, healthcare providers and advocacy groups predominantly use "advanced HIV" or "late-stage HIV" when referring to the most severe stage of the disease, and avoid the casual use of "severe HIV"

It might be advanced HIV. All I know is that we stopped saying AIDS about fifteen years ago but honestly there isnt much reason to talk about that sort of end stage of the disease unless you directly work with those patients all the time. I see healthy perinatal women living with HIV and that's how we talk about it.

Maybe the phrase is different, but this does make those of us who weren't aware that using the word Aids is no longer common.

Even though many campaign groups still have this as part of their name.

Well that's what has come up when management types have said "never use it".
Especially by people who have HIV and now work to support others newly diagnosed or new to the country. Those service users understand the term "AIDS" and what that means in terms of the progression of HIV to some extent. Refusing to use the term or attempting to correct them will interfere with communication and overall relationship.