title: Changing risk factors for HIV infection.
abstract: BACKGROUND
  HIV infection in women is a growing problem in developing countries. Risk factors for HIV infection vary from country to country and may change with time.
  
  
  METHODS
  We describe a retrospective review of the epidemiologic characteristics and associated gynecologic diseases of all HIV-infected women seen at two tertiary-care hospitals in Mexico City.
  
  
  RESULTS
  One hundred thirty consecutive patients were included in the study from March 1985 to January 1996. Mean age at HIV diagnosis was 36.2 years (range: 16-76). Of the 75 women diagnosed with AIDS prior to 1992, 58 (69%) were infected through blood transfusion and 17 (20%) through sexual contact. After January 1992, 11 (23%) acquired infection through blood transfusion and 28 (60%) through sexual contact; these differences were statistically significant (p <0.0001). Prior to 1992, 66 (90%) women presented in stage IV, whereas after that year only 29 (51%) (p <0.001) presented in stage IV. Of 92 patients on whom a cervico-vaginal smear was carried out, human papillomavirus infection was identified in 22 (24%) women, nine (9.8%) had morphologic evidence of a cervical intraepithelial neoplasia (four with mild or moderate dysplasia and five with in situ cervical carcinoma). Four patients had invasive cervical carcinoma.
  
  
  CONCLUSIONS
  The main risk factor for HIV infection in Mexican women with AIDS changed from transfusion acquired to sexually acquired in 1992. As a country, we were successful in providing safe blood but failed to prevent sexual transmission. Our patients had a high frequency of cervical carcinoma and precursor lesions associated with human papilloma virus.
authors.affiliation: Departamento de Enfermedades Infecciosas, Instituto Nacional de Cancerología (INCAN), Mexico City, Mexico. volkow@infosel.net.mx
authors.forename: Patricia
authors.initials: P
authors.lastname: Volkow
authors.forename: Alejandro
authors.initials: A
authors.lastname: Mohar
authors.forename: José-Juan
authors.initials: JJ
authors.lastname: Terrazas
authors.forename: José-Rogelio
authors.initials: JR
authors.lastname: Pérez-Padilla
authors.forename: Diana
authors.initials: D
authors.lastname: Vilar-Compte
authors.forename: Dora
authors.initials: D
authors.lastname: Carranza
authors.forename: Juan
authors.initials: J
authors.lastname: Sierra-Madero
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D005831:Genital Diseases, Female / Q000453:epidemiology*; D015658:HIV Infections / Q000453:epidemiology* / Q000635:transmission*; D006801:Humans; D008297:Male; D008800:Mexico / Q000453:epidemiology; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate