Doctors turn Aids study spotlight on women

Aids physician Jerry Cade says his patients are different from the subjects in most research studies. Dr Cade's patients are women.

Women have been excluded from clinical trials in the past because most Aids patients have been men. But now women make up more than half of the 36.1 million adults infected with HIV worldwide.

The percentage of newly diagnosed United States women has doubled over the past 10 years, making women the fastest-growing HIV-infected population in the US.

Dr James Witek, an MCP Hahnemann University Aids researcher in Philadelphia, said that European countries were reporting similar increases as transmission of the virus through heterosexual sexual contact became more prevalent.

The inclusion of more women in research studies became increasingly important, because female patients responded differently to the disease and to treatment, said Dr Witek.

Judy Delmar, a doctor treating Aids patients in San Antonio, Texas, said: "The disease doesn't necessarily behave the same way in both genders. It's just a different disease in women."

Drs Delmar, Witek and Cade were among 50 Aids physicians and advocates who gathered recently in Chicago to discuss the latest developments in treatment.

The need for more women subjects in Aids research was a concern repeated throughout the two-day conference.

Dr Carlos Arboleda, another attending, said the differences between men and women started with detection.

"Women are diagnosed later in the disease than men because they do not perceive themselves as at risk," said Dr Arboleda, treatment director at the National Minority Aids Council in Washington.

Cathy Christeller, executive director for the Chicago Women's Aids Project, said that once a patient was diagnosed, the next step was balancing effective treatment with minimising side-effects, an especially tough task for doctors treating female patients.

"If the doctors don't know how to fine-tune treatment for gender, it makes it difficult. We are trying to educate women that there are really good treatments available, but we are kind of handicapped."

Determining an appropriate treatment option for women could be difficult because women generally weighed less and had lower viral loads than men who were just as sick.

Viral loads counted the number of HIV-infected CD4 cells, which normally orchestrated the immune system's response to disease by signalling to other cells to attack invaders.

Freddie Oaks, a counsellor at Project Inform in San Francisco, said that women needed to be their own advocates, learning about the disease and the treatment options available.

"Women are having a rough time of it. We live in a society where men's health is more important than women's health."

- REUTERS