Gender Differences in Progression to AIDS and Death After HIV Diagnosis

Background: The underlying mechanisms of HIV infection and its social and economical consequences significantly differ between men and women. Objectives: The aim of this study was to examine gender differences in Human Immunodeficiency Virus (HIV) progression to acquired immune deficiency syndrome (AIDS) and death among people living with HIV in Shiraz. Patients and Methods: A historical cohort study (1996 to 2012) was conducted using data obtained from Shiraz voluntary counseling and testing center. Subjects infected by HIV, who were 17 years or older and antiretroviral therapy (ART) naive were included in this study. Basic demographic information, such as age at diagnosis, current age, gender, mode of HIV transmission, and education were extracted based on the dates of the reported positive Western-Blot (WB) tests. Results: Among the 1721 enrolled subjects who met the inclusion criteria, 1456 (84.6%) were male and 265 (15.4%) were female. Among all transmission routes, injecting drug use (IDU) was the most frequent for men (1262 = 86.7%) and sexual transmission was the most frequent for women (226 = 85.3%). The mean (SE) time of HIV to AIDS was 35.98 ± 0.95 months; 38.04 ± 1.09 for men and 27.85 ± 1.80 for women (P < 0.001, log rank test). Mean (SE) time of HIV to death was 31.74 ± 1.36 months; 31.83 ± 1.41 for men and 31.15 ± 4.47 for women (P = 0.773, log rank test). Conclusions: This study showed that HIV-infected women, as compared with men, had faster progression to AIDS. This result may indicate that women refer to health centers late, so they are diagnosed during the developed stages of the infection. Uninvited and multivariate tests were used and no difference was found between survival time of men and women.