Need a Break from AIDS Denialism? How about some plain old HIV risk denial?

British women 'in denial' over growing HIV risk

Unprotected heterosexual sex is not seen as a danger to health, survey finds

By Amelia Hill, The Guardian / The Observer, Sunday 28 February 2010

British women are putting themselves at increasing risk of HIV infection,ccording to experts, with a new survey revealing that almost three-quarters have never been tested for the virus and a significant proportion admitting that nothing could persuade them to be examined. The poll of 1,000 adults in the UK has revealed that a false sense of security is seeing women neglecting to protect themselves against catching the virus.

"Over the past decade, this specific demographic has been hard hit with a steady rise in HIV infection," said Nancy Mahon, executive director of the MAC Aids Fund, which commissioned the research. "Our survey results expose significant gaps in HIV awareness and education among British women, leading to startlingly low assessments of risk of infection. Despite this epidemic in the UK, experts stress that women need to be re-alerted to the danger of having unprotected sex," she added. "They highlight the need for heightened awareness and education about safe sexual choices."

The survey found that 37% of British women who say they have engaged in sexual intercourse without a condom in the past five years were uncertain whether their partner was sleeping with other people. It also found that British women are in denial over the risk of infection. Up to 60% of those questioned admit they do not believe it is an issue affecting women in their community, with 73% never having been for a test. In addition, nearly one in six British women – 16% – admit that nothing could make them get tested for HIV.

"Popular reasoning when it comes to not using condoms includes trusting their partner is not HIV-positive (35%), using another form of birth control (35%), or simply a 'no-risk' attitude to sexually transmitted diseases (27%)," said Mahon. "But in addition to this low- or no-risk perception, British women feel they lack the power in their relationships to negotiate safe sex."

According to the Terrence Higgins Trust, the number of people contracting HIV as a result of heterosexual sex in the UK has been rising steadily over recent years. In 2008, nearly 7,300 were diagnosed, almost three times the 1998 figure and the third highest number of people diagnosed with HIV in a single year. Almost 60% of those diagnosed had acquired the infection through heterosexual contact.

"Since the mid-1990s, public and political complacency has grown about the risks of HIV and other sexually transmitted infections in the UK," according to Lucy Handford of the Higgins trust. "Partly because of this, the number of new cases of HIV being diagnosed began to rise. Today, gay men continue to be most at risk from HIV, but the UK is also now very much a part of the global epidemic: there are now more people than ever before living with HIV in the UK."

HIV progresses faster in women than in men with similar levels of HIV in the blood. A possible reason, posited last year by American scientists, could be gender differences in the immune system. The increased virulence of the disease in women means early diagnosis is a crucial factor when determining how well treatments work and, ultimately, how well the patient will do over the long term. Despite the importance of swift diagnosis, 36% of HIV-positive women in the UK are in an advanced stage of the disease by the time they receive a diagnosis.

Women need to be re-alerted to the danger of having unprotected sex, said Dr Anke Ehrhardt, director of the HIV Centre for Clinical and Behavioural Studies in New York, and professor of medical psychology at the College of Physicians and Surgeons' department of psychiatry.

"Despite the widespread availability of condoms throughout the UK, women are not using them," she said. "We used to say in the 1980s that the HIV virus doesn't discriminate and anybody can become infected if exposed. But people always saw it as a discriminatory disease that affects only certain people. The continued lack of information hasn't helped to counter that stigma."

Ehrhardt says that starting sex education early, promoting strong female role models and continuing sexual education programmes would help to encourage women to get tested and use protection. "Integrated sex education is also imperative to reach women every time they are in a healthcare setting. Whether a woman is seeking primary health services, prenatal care or reproductive health services, education and testing should be top priorities for patients and medical professionals alike."

Kevin Osborne, senior HIV adviser at the International Planned Parenthood Federation, agreed. "We need to find ways of providing comprehensive service care for women – where it's not just an HIV service but enables women to seek out comprehensive health and other services in which HIV testing is an integrated part. We need to make standardised HIV testing a priority so that every woman knows their status and can make informed decisions."