Women and human immunodeficiency virus: unique management issues

Women currently account for an increasing proportion of the US population infected with human immunodeficiency virus (HIV). Although women suffer from similar HIV-related complications as men, they also can have unique gynecologic manifestations, such as cervical dysplasia or severe pelvic inflammatory disease. Other gender-specific management issues include contraception and pregnancy. Fortunately, today the perinatal HIV transmission rate can be lowered to less than 2% with appropriate management. More couples, including those discordant for HIV infection, are opting to pursue conception. Providers caring for HIV-infected women should be knowledgeable about reproductive choices, including the full array of available options. Strategies shown to improve access of health care to HIV-infected women include integrating gynecologic services with primary care, daily availability of medical services, provision of transportation, and provision of on-site childcare.