Women and the AIDS epidemic: no longer hidden

1. Women acquire HIV infection along one of three routes: parenteral, sexual, or vertical (perinatal). The HIV/AIDS epidemic among women in the US is growing primarily through parenteral and heterosexual exposures, which are tightly linked to social issues of substance abuse. 2. The majority of AIDS clinical trial participants have been white men. Differences in male and female physiology, hormonal influences on drug pharmacokinetics, and the social context of disease may render protocols ineffective or even harmful for women. 3. To respond effectively to the AIDS epidemic among women in the US, major public health issues, such as access to care, availability of family planning and drug treatment services, and racial discrimination, must be addressed.