HIV Affecting Both Men and Women
Sophia Zagorski, Yeliennis Tamayo, Jamir Akins, Chamy Lam
College of Southern Nevada
Soc 101 - 4001 - 4002 FALL 2025
Professor Flora Rudacille
Human Immunodeficiency Virus (HIV) remains one of the most significant ongoing public health challenges in the world, despite major advances in treatment, prevention, and scientific understanding. More than four decades after its discovery, HIV continues to impact millions of individuals globally, disproportionately affecting certain genders, regions and key populations. As of 2024, an estimated 39-40 million people are living with HIV, and approximately 1.3 million new infections occur annually, with the highest burden found in subSaharan Africa and among marginalized groups in other regions (UNAIDS, 2025; World Health Organization, 2025). Although modern antiretroviral therapy has transformed HIV into a manageable chronic condition and significantly reduced transmission risk, persistent inequities in access to care, socioeconomic barriers, stigma, and biological risk factors continue to drive the epidemic. Understanding the multidimensional nature of HIV, including its biological pathways, social determinants, gender disparities, and evolving treatment landscape is vital for developing effective, equitable public health strategies.
HIV is a virus that attacks the immune system, specifically targeting CD4 T-cells, and weakens the body’s ability to fight infections and disease. Without treatment, HIV progresses through stages of acute infection, chronic infection, and eventually AIDS, the most advanced and life-threatening form. The Mayo Clinic (2024) notes that early symptoms may resemble common viral illnesses, with fever, swollen lymph nodes, and sore throat making early detection difficult. Transmission occurs primarily through unprotected sexual contact, sharing of needles, from mother to child during pregnancy or breastfeeding, and less commonly through blood transfusions in settings where screening is inadequate. Although the basic mechanisms of transmission are well understood, the likelihood of transmission is strongly linked to an individual’s viral load. Evidence demonstrates that people living with HIV who are on effective antiretroviral therapy (ART) and maintain viral suppression below 200 copies/mL do not sexually transmit the virus, a concept known as U=U (Undetectable = Untransmittable) (Rodger et al., 2019). Systematic reviews further confirm that transmission risk is effectively nonexistent under conditions of sustained viral suppression (Broyles et al., 2023).
While HIV is a global epidemic, its distribution is deeply unequal. Sub-Saharan Africa remains the region most heavily affected, accounting for approximately two-thirds of all global HIV cases (UNAIDS, 2025). Young women and adolescent girls in this region face disproportionately high rates of infection due to a combination of gender inequality, socioeconomic vulnerability, limited access to education, and structural barriers in healthcare. Globally, gendered risk patterns vary based on regional context. In high-income countries such as the United States and Western Europe, men who have sex with men continue to represent the majority of new infections, with 67% of U.S. new diagnoses occurring in this population (HIV.gov, 2025). These differences reflect not only biological risk factors but also cultural norms, stigma, and unequal access to prevention tools. In Eastern Europe and Central Asia, where 94% of new infections occur among people who inject drugs and other key populations, socioeconomic disparities and criminalization contribute to rising incidence (CDC, 2024; UNAIDS, 2025). These regional variations highlight that HIV transmission is shaped by a complex interplay of biological susceptibility, social structures, and public health policy.
Biological differences help explain why women and men experience HIV differently. Women have nearly double the per-act risk of acquiring HIV during vaginal intercourse compared to men due to factors related to genital tract inflammation, sexually transmitted coinfections, and the composition of the vaginal microbiome (Scully, 2018). Hormonal differences further influence immune response, altering susceptibility. In sub-Saharan Africa, high rates of HSV-2 coinfection significantly increase HIV vulnerability because genital inflammation facilitates viral entry. Conversely, men benefit from certain protective factors, such as the reduced risk of HIV acquisition associated with circumcisions, which decreases the amount of susceptive foreskin tissue (Scully, 2018). These biological determinants reveal why gender-specific prevention strategies are essential, especially in regions with limited healthcare access.
Beyond the physical aspects of HIV, the virus also has profound neurological and cognitive implications, even among individuals on effective ART. Research indicates that traditional classifications of HIV-associated neurocognitive disorders (HAND) may overestimate impairment, leading to stigmatization and inaccurate assumptions about cognitive decline. Nightingale et al. (2023) argue for new diagnostic frameworks that account for broader social, medical, and neurobiological factors, emphasizing a shift toward more accurate assessment of HIV-associated brain injury. As HIV-positive individuals live longer due to effective treatment, understanding these long-term outcomes becomes increasingly important for improving quality of life and developing supportive care strategies.
Modern HIV treatment has drastically reshaped the epidemic. Antiretroviral therapy not only restores immune function but also prevents transmission. Recent cohort studies demonstrate that newer ART regimens, such as dolutegravir-based therapy, offer improved viral suppression and retention outcomes but have not always been equitably accessible. Dorward et al. (2023) found that women, particularly young and pregnant women, were less likely to initiate or transition to dolutegravir despite its benefits, revealing structural gender inequities within healthcare systems. Meanwhile, innovative scientific research is exploring the future possibilities of HIV cure strategies. Mathematical modeling studies suggest that sustained viral remission or eradication could substantially reduce HIV incidence, but partial or temporary remission without careful monitoring may increase transmission risk (De Bellis et al., 2025). These findings highlight both the promise and the complexity of cure-oriented research.
Public awareness and education remain essential components of HIV prevention. Despite progress, stigma remains a major barrier worldwide, discouraging individuals from seeking testing, treatment, or preventative measures such as PrEP (pre-exposure prophylaxis). Community-based awareness efforts show that even with declining global HIV rates, millions remain undiagnosed or untreated, and misinformation continues to circulate, particularly among youth and marginalized groups (SEO invigo, 2025; Williams, 2024). The World Health Organization (2025) emphasizes that achieving the global 95-95-95 targets ensuring that 95% of people know their status, 95% of diagnosed individuals receive ART, and 95% of those on ART achieve viral suppression is critical to ending the epidemic by 2030. Expanding prevention tools such as long-acting PrEP, condoms, harm-reduction programs, and widespread testing remains crucial for reducing new infections and addressing disparities.
HIV continues to challenge global health systems, but it is also a disease that can be effectively managed, prevented and controlled with the right strategies. Scientific evidence clearly demonstrates that ART eliminates the risk of sexual transmission when viral suppression is achieved, affirming the power of treatment not only as therapy but also as prevention. However, the persistent gender disparities, regional inequalities, and social determinants of health underscore that biomedical advances alone are not enough. Addressing HIV requires a coordinated global commitment to equitable healthcare access, gender-sensitive prevention strategies, social support, and ongoing public education. As research continues to advance toward the possibility of an HIV cure, the preservative remains to strengthen prevention, reduce stigma, and ensure that all individuals regardless of geography, gender, or socioeconomic status have access to life-saving resources. With a comprehensive and inclusive public health approach, meaningful progress toward ending the HIV epidemic is both possible and within reach.
References
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