The AIDS epidemic among Spanish women.
BACKGROUND
The number of female cases of AIDS in Spain continues to rise. This paper describes the epidemiological pattern involved and identifies differences compared to heterosexual males.


METHODS
An analysis based on data gathered via the Spanish AIDS surveillance system was carried out on cases among females aged > 12, broken down by reporting year, age, transmission category and area of residence. A comparison was run against cases among heterosexual males.


RESULTS
By December 1993, 22,114 cases of AIDS among patients aged > 12 had been reported, 3812 (17.2%) involving females. Although a rise was to be observed in the number and percentage of female cases reported each year, climbing to 1039 cases in 1993 and accounting for 18.5% of all cases in adults, the heterosexual male-to-female ratio remained relatively constant at around 3.8:1. Average age at diagnosis was higher among heterosexual males than among females (31.1 versus 29.8; P < 0.0001). Intravenous drug users (IVDU) accounted for 71.7% and heterosexual contact for 19.4% of women with AIDS, against 81.7% and 5.8% respectively in males. Until 1993 the cumulative rate for AIDS stood at 221 cases per million adult females.


CONCLUSIONS
Intravenous drugs, whether through direct use or heterosexual relations with IVDU partners, are the principal cause of female AIDS in Spain. In females, the epidemic exhibits different characteristics compared to that in males.
Castilla
J
J
National Centre for Epidemiology, Carlos III Institute of Health, Madrid, Spain.
García-Puente
E
E
D000163:Acquired Immunodeficiency Syndrome / Q000453:epidemiology* / Q000635:transmission; D000293:Adolescent; D000328:Adult; D004196:Disease Outbreaks; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D012042:Registries; D012737:Sex Factors; D012725:Sexual Behavior; D013030:Spain / Q000453:epidemiology; D015819:Substance Abuse, Intravenous