South Florida is an epicenter for HIV in the United States. In the past, the HIV population was predominantly drug users and gay males. Today, HIV is increasingly seen in the straight population, many of them women 18 to 30.
Florida has one of the highest rates in the United States for HIV-infected women, especially new cases.
With World AIDS Day on Monday and health officials eager to combat the trend, University of Miami doctors have planted themselves in the middle of Miami-Dade communities to get people tested, promote healthy planning and conduct research on the long-term effects of the virus and what makes women more at risk of infection.
According to the Florida Department of Health in Miami-Dade County, one in 99 residents lives with HIV or AIDS (one in 67 males and one in 178 females).
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“Through the decades of my research, women’s issues always tended to be unrepresented,” said Dr. Margaret Fischl, professor of medicine and director of AIDS Clinical Research Unit at UM Miller School of Medicine.
One focus at UM is pre-conception counseling, a look at HIV-positive women’s sexual behavior before they get pregnant. The project gives women the information they need if they want to have children.
“Planning is not something that people do well, HIV-positive or -negative, especially when it comes to becoming pregnant,” said Dr. Deborah Jones Weiss, research associate professor in the Miller School’s Department of Psychiatry and Behavioral Sciences.
Another project looks at other viruses, including human papillomavirus or HPV, the most common sexually transmitted infection that is associated with cervical cancer.
UM is conducting research and screening women for cervical, anal and oropharyngeal cancer.
“Now we are doing Pap smears to detect things like anal cancer,” said Dr. Maria Alcaide, associate professor of clinical medicine at the Miller School’s Division of Infectious Disease. “That’s something that is not typically screened for, so UM is taking a step forward.”
The team is also working on the Wash Project, a look at factors that affect how women can either acquire HIV infections or transmit infections to their partners.
Feminine hygiene such as douching can put a woman at risk for certain infections, making them more susceptible to getting or transmitting HIV, Weiss said.
“Think of the vagina as a contained environment. Some of the things that women do as part of regular feminine hygiene can change this environment, and not in a good way,” she said.
Fischl believes looking at these factors as well as social behavior, whether HIV-positive or -negative, will provide insight into how to help people with HIV and to help others avoid infection.
“We actually interview people pretty intensely,” Fischl said, ”and it is remarkable how they feel that no one has paid attention in their lives.”