CRS Report for Congress
Congressional Research Service, The Library of Congress
91-607 L

Bonnie F. Mangan
Senior Bibliographer, Science Policy
Library Services Division
July 1991

Summary

This bibliography focuses on the AIDS epidemic and its effects on women. It explores the spread of human immunodeficiency virus infection among women and notes that women have been relatively neglected in AIDS research programs. The social, legal and political issues surrounding women and AIDS are examined as well as educational programs that can help prevent AIDS in women.

For related citations on women's health, see Women's Health Issues: Selected References, 1986-1991 (91-606 L).

Contents

• Research and Epidemiology
• Social, Political, Legal and Ethical Issues
• Education and Prevention
   

Research and Epidemiology

Antibody to human immunodeficiency virus in female prostitutes.
JAMA [Journal of the American Medical Association], v. 257, Apr.17,1987: 2011-2013. LRS87-2840
Reports that "the major risk factor for HIV infection in prostitutes appears to be IV-drug abuse. Women with unprotected vaginal exposures also appear to be at greater risk than those whose male partners always used condoms. When used properly and consistently with each sexual exposure, latex condoms should greatly reduce the sexual transmission of HIV."

Chin, James.
Current and future dimensions of the HIV/AIDS pandemic in women and children.
Lancet, v. 336, July 28,1990: 221-224. LRS90-8405
"The WHO estimates that during the first decade of the HIV/AIDS pandemic there were about 500,000 cases of AIDS in women and children, most of which have been unrecognized. During the 1990s, WHO estimates that the pandemic will kill an additional 3 million or more women and children world wide."

Crane, Tricia.
The battle against AIDS intensifies for women.
Advocate, no. 563, Nov. 6, 1990: 42-45. LRS90-10997
"Women now constitute the fastest-growing group of people with AIDS. Women who are in heterosexual relationships but do not know that their partners are bisexual or use I.V. drugs are among the most rapidly growing groups at risk for AIDS."

Epidemiology of women with AIDS in the United States, 1981 through 1990: a comparison with heterosexual men with AIDS.
JAMA [Journal of the American Medical Association], v. 265, June 12,1991: 2971-2975. LRS91-3962
Finds that 51% of women with AIDS were infected through intravenous drug use and 29% through heterosexual contact, with the proportion attributed to heterosexual contact increasing from 1986 through 1990. "Understanding the epidemiology of HIV infection and AIDS in women is essential for developing better public health strategies and allocating resources more effectively to prevent the spread of HIV to women and children. National AIDS surveillance provides information on current HIV-related morbidity and mortality and continues to be essential in accurately predicting national trends and patterns of HIV infection in the United States."

European Collaborative Study. Children born to women with HIV-l infection: natural history and risk of transmission.
Lancet, v.337, Feb. 2,1991: 253-260. LRS91-562
"600 children born to HIV-infected women by June 15, 1990, in ten European centres were followed to study the natural history of HIV infection and the vertical transmission rate. They were seen at birth, every 3 months up to 18 months of age, and every 6 months thereafter. At last follow-up, 64 children were judged to be HIV infected and 343 had lost antibody and were presumed uninfected."

Evaluation of heterosexual partners, children, and household contacts of adults with AIDS.
JAMA [Journal of the American Medical Association], v. 257, Feb. 6,1987: 640-644. LRS87-758
This study found that the overall incidence of AIDS infection among spouses of patients with AIDS was 58%, which demonstrates a higher rate of transmission of the AIDS virus among heterosexual couples. The findings also supported the concept that the AIDS virus is not spread through close contact other than intimate sexual or blood exposures.

Guinan, Mary E. Hardy, Ann.
Epidemiology of AIDS in women in the United States 1981 through 1986.
JAMA [Journal of the American Medical Association], v. 257, Apr. 17,1987: 2039-2042. LRS87-2841
"An analysis of 1819 cases of acquired immunodeficiency syndrome (AIDS) in women reported between 1981 and 1986 showed that the majority of women with AIDS were intravenous drug users. The second most common risk group was heterosexual contact with a person at risk for AIDS. The proportion of women with AIDS in this risk group increased significantly between 1982 and 1986, from 12% to 26%. This trend may prove to be a good market for following trends in heterosexual transmission. Since the majority of childhood AIDS cases are a result of perinatal transmission from the mother, trends in AIDS cases in women may also predict future trends for AIDS in children."

HIV seroprevalence in newborns in New York State.
JAMA [Journal of the American Medical Association], v. 216, Mar. 24-31,1989: 1745-1750. LRS89-2167
Reports on the ongoing New York State newborn seroprevalence study to monitor the rate of HIV infection. "The prevalence of human immunodeficiency virus (HIV) infection was determined in women at the time of childbirth throughout New York State between November 30, 1987, and November 30,1988. Mandatory blood specimens (276,609) obtained from all newborns were examined for HIV. The overall HIV seroprevalence rate was 0.66% (1816 newborns), with 0.16% in Upstate New York and 1.25% in New York City. Rates for newborns whose mothers were aged 20 to 29 years (1.30%) and 30 to 39 years (1.35%) were significantly higher than rates for those with mothers younger than 20 years of age (0.72%). Rates of seropositivity were higher among blacks (1.8%) and Hispanics (1.3%) than among whites (0.13%)."

HIV-1, HIV-2, and HTLV-I infection in high-risk groups in Brazil.
New England journal of medicine, v. 320, Apr. 13, 1989: 953-958. LRS89-2234
Considers "that in Brazil HIV-l infection is already well established among homosexuals, bisexuals, and lower-classes female prostitutes, with bisexual men probably acting as a bridge between the heterosexual and homosexual communities, that HTLV-l infection is prevalent in groups at risk for AIDS, and that HIV-2 infection has already been introduced into the country."

Holmes, King K. Karon, John M. Kreiss, Joan.
The increasing frequency of heterosexually acquired AIDS in the United States, 1983-88.
American journal of public health, v. 80, July 1990: 858-863. LRS,90-4853
"Provides an analysis of trends in the frequency and percentage of cases of AIDS in the United States thought to have been acquired heterosexually, together with a perspective on heterosexual transmission of HIV (human immunodeficiency virus) in the context of a general overview of heterosexually transmitted infections." Finds that among women, the incidence of AIDS from heterosexual contact is over 11 times greater for Blacks and Hispanics than whites.

Lynch, Catherine A.
Statement to the National Institutes of Health Office of Research on Women's Health.
New York, Gay Men's Health Crisis, 1991. 11 p.LRS91-4476
This testimony presented at the public hearing before the Office of Research on Women's Health of NIH stresses that "women represent the fastest-growing group of people with CDC-defined AIDS, yet the federal government has seen fit to allocate no resources for education to enable women to prevent HIV transmission, no resources for research into the dynamics of transmission of HIV to women, no resources for biomedical research on the manifestations of HIV in women."

Minkoff, Howard L.
Care of pregnant women infected with human immunodeficiency virus.
JAMA [Journal of the American Medical Association], v. 258, Nov. 20, 1987: 2714-2717. LRS87-9648
Reviews "issues related to counseling and antepartum, intrapartum, and postpartum care of seropositive pregnant women."

New York State HIV Seroprevalence Project.
American journal of public health, v. 81, May 1991, suppl.: 1-63. LRS91-2206
Partial contents.--New York State HIV Seroprevalence Project: goals, windows, and policy consideration, by Lloyd F. Novick.--Geographic distribution of newborn HIV seroprevalence in relation to four sociodemographic variables, by Dale L. Morse and others.--Projection of AIDS incidence in women in New York State, by Lawrence Lessner. --HIV seroprevalence in a facility for runaway and homeless adolescents, by Rachel L. Stricof and others.--The AIDS epidemic in New York State, by Perry F. Smith and others.

Prevalence of antibody to HIV-1 among entrants to US correctional facilities.
JAMA [Journal of the American Medical Association], v.265, Mar. 6, 1991: 1129-1132. LRS91-866
"Prevalence of antibody to the human immunodeficiency virus type 1 (HIV-1) was assessed among 10,994 consecutive male and female entrants to 10 correctional systems in the United States. The HIV-l seroprevalence for the 10 systems ranged from 2.1% to 7.6% for men and 2.5% to 14.7% for women; seroprevalence among women was higher than among men across nine of 10 systems."

Prevalence of HIV infection in childbearing women in the United States: surveillance using newborn blood samples.
JAMA [Journal of the American Medical Association], v. 265, Apr. 3,1991: 1704-1708. LRS91-2683
"Nationwide, an estimated 1.5 per 1000 women giving birth to infants in 1989 were infected with HIV. Assuming a perinatal transmission rate of 30%, we estimate that approximately 1900 newborns acquired HIV infection during one 12-month period. Preventing transmission of HIV infection to women and infants is an urgent public health priority."

Prospective study of human immunodeficiency virus infection and pregnancy outcomes in intravenous drug users.
JAMA [Journal of the American Medical Association], v. 261, Mar. 3,1989: 1289-1294. LRS89-4622
"To determine the effects of human immunodeficiency virus (HIV) infection on pregnancy outcomes, we prospectively studied female intravenous drug users in a methadone program in New York City .... Results suggest that asymptomatic HIV infection is not associated with a decreased pregnancy rate or an increased risk of adverse pregnancy outcomes in intravenous drug users, and that an acceleration in HIV-disease status during pregnancy is uncommon."

Seroprevalence and risk factors for HTLV-TJII infection among female prostitutes in the United States.
JAMA [Journal of the American Medical Association], v. 263, Jan. 5,1990: 60-64. LRS90-688
"Tested 1305 female prostitutes from eight areas of the United States for antibodies to human T-cell lymphotropic virus type I/II. Overall 6.7% were human T-cell lymphotropic virus type VII seropositive."

Sides, W. Hampton.
Of lovers and their friends.
Washingtonian, v. 22, Nov. 1986: 127-135. LRS86-9862
Reports on the growing number of women who have been exposed to AIDS as a result of sexual contact with bisexual men.

U.S. Congress. House. Select Committee on Children, Youth, and Families.
Placing infants at risk: parental addiction and disease.
Hearing, 99th Congress, 2nd session. May 21,1986. Washington, G.P.O., 1986. 144 p. KF27.5.C48 1986c

Wolfe, Leslie R.
Statement to Task Force on Opportunities for Research on Women's Health, June 3,1991.
Washington, Center for Women Policy Studies, 1991. 11 p. LRS91-4842
Describes the work of the Center's National Resource Center on Women and AIDS which works to address the AIDS crisis from women's perspectives. Stresses that "in spite of the growing numbers of women affected by the epidemic, women have been relatively neglected in research programs. Women continue to be defined by federal research agencies and by most biomedical and social/psychological researchers as vectors of transmission to men and fetuses. HIV/AIDS research on women, when it has received attention, has focused on women's roles as potential infectors, through perinatal and female-to-male transmission, rather than on their experiences and needs as infected individuals and patients."

Social, Political, Legal and Ethical Issues

Working Group on HIV Testing of Pregnant Women and Newborns. HIV infection, pregnant women, and newborns.
JAMA [Journal of the American Medical Association], v. 264, Nov. 14,1990: 2416-2420. LRS90-10996
Proposes a 10-point program for HIV testing for pregnant women and newborns. Advocates "informing all pregnant women and new mothers about the HIV epidemic and the availability of testing."

AIDS.
Journal of the National Association of Social Workers, v. 36, Jan. 1991: 1-73. LRS91-144
Women and HIV disease: an emerging social crisis, by Denise Stuntzner-Gibson.--Social workers' knowledge about AIDS: a national survey, by K. Jean Peterson.--AIDS-related training in U.S. schools of social work, by Yolanda E. Diaz and Jeffrey A. Kelly.--Stigma management and gay identity development, by Roy Cain.

AIDS and intravenous drug use.
AIDS & public policy journal, v. 3, no. 2, 1988: whole issue (52 p.) LRS88-8045
Partial contents.--Intravenous drug abuse and AIDS in minorities, by Lawrence S. Brown, Jr. and Beny J. Primm.--Prostitutes and AIDS: public policy issues, by Judith Cohen, Priscilla Alexander, and Constance Wofsy.--Intravenous drug use and human immunodeficiency virus (HIV) infection in prison, by David Vlahov and B. Frank Polk.--AIDS and intravenous drug users in Australia, by Alexander Wodak and Bruce M. Whyte.--Women, AIDS, and public policy, by Janet L. Mitchell.

AIDS: the women.
Edited by Ines Rieder and Patricia Ruppelt. San Francisco, Cleis Press, c1988. 251 p. RC607 A26 A3645 1988

Anastos, Kathryn. Marte, Carola.
Women--the missing persons in the AIDS epidemic.
Health/PAC bulletin, v. 19, winter 1989: 6-13. LRS89-12987
"Our current understanding of the public health problem posed by the acquired immunodeficiency syndrome (AIDS) in women is seriously distorted by the underrepresentation of women in official data and the misrepresentation of their disease."

Women--the missing persons in the AIDS epidemic.
Health/PAC bulletin, v. 20, spring 1990: 11-18. LRS90-4008
"In this article the authors examine the issues of reproductive rights and HIV testing in women hospitalized for childbirth."

Bedward, Royce Richard.
Aids testing of rape suspects: have the rights of the accused met their match?
University of Illinois law review, v. 1990, no. 2, 1990: 347-374. LRS90-12278
"This note begins with an overview of the current state of knowledge on AIDS and a discussion of the drug AZT. It then discusses the current statutes allowing the HIV testing of rape suspects. Part III analyzes the statutes, and the entire concept of compelled testing of criminal suspects, in light of probable constitutional challenges on fourth amendment, equal protection, due process, right to privacy, and first amendment grounds .... Finally, this note proposes model legislation that affords the rape suspects greater rights than the mandatory testing statutes currently in existence."

Boyne, Shawn Marie.
Women in prison with AIDS: an assault on the constitution?
Southern California law review, v. 64, Mar. 1991: 741-796. LRS91-2089
"Part II of this Note examines the scope of this problem. Part m focuses on the nature of an individual's constitutional rights in prison and the key legal theories advanced to protect prisoners infected with the HIV virus. Finally, Part IV explores the implications of this crisis for women and the criminal justice system."

Gelman, David.
The mind of the rapist.
Newsweek, v. 116, July 23,1990: 46-50, 52-53. LRS90-5497
"A startling rise in sex crimes and the notoriety of cases like the Central Park jogger give new urgency to the question: why do men rape?" Includes sidebar, A frightening aftermath: concern about AIDS adds to the trauma of rape, by Eloise Salholz.

Institute of Medicine (U.S.). Committee on Prenatal and Newborn Screening for HIV Infection.
HIV screening of pregnant women and newborns. Washington,National Academy Press, 1991. 146 p.
Though the Committee opposes any mandatory HIV screening program it endorses the continuation of anonymous newborn screening for surveillance purposes. Recommends that all pregnant women should be informed about HIV infection, its modes of transmission, high risk behavior and ways of reducing risk.

A Jailhouse lawyer's manual supplement on health and family law.
Columbia human rights law review, v. 20, spring 1989: S1-S107. LRS89-11907
Contents.--The right to adequate medical care.--AIDS in prison.--Prison marriages.--Prenatal and postnatal rights of incarcerated mothers.--The incarcerated mother's rights with respect to her children.--Sexual abuse and harassment.

Levin, Betty Wolder. Driscoll, John M. Fleischman, Alan R.
Treatment choice for infants in the neonatal intensive care unit at risk for AIDS.
JAMA [Journal of the American Medical Association], v. 265, June 12,1991: 2976-2981. LRS91-3961
Investigates attitudes surrounding treatment of infants in neonatal intensive care units who were born to women with the human immunodeficiency virus. Surveyed "professionals at six neonatal intensive care units in New York City. A significant proportion of the 247 respondents recommended less aggressive treatment for non-HIV-related conditions for infants at risk for HIV compared with those not at risk .... Concludes that perceived HIV status may influence decision making about treatment for non-HIV-related conditions for critically ill patients, including infants not actually infected. Ethical issues concerning the relevance of HIV status need to be examined."

MacDonald, Paul H.
AIDS, rape, and the fourth amendment: schemes for mandatory AIDS testing of sex offenders.
Vanderbilt law review, v. 43, Oct. 1990: 1607-1636. LRS90-10434
"This Note examines the issues surrounding mandatory AIDS screening of sex offenders and some of the contrasting approaches to the problem with an emphasis on the legislative reactions to the controversy in New York and California."

McLennan, Juliette C.
Equality, development, and peace: needs for the advancement of women.
Washington, U.S. Dept. of State, Bureau of Public Affairs, 1990. 3 p. (Current policy no. 1262) LRS90-5035
McLennan, U.S. representative to the 34th session of the Commission on the Status of Women, held on March 5, 1990, speaks about eight areas of concern. The topics discussed are leadership, economic reform measures, literacy, environment, refugee women, AIDS, violence, and communications concerning violations of women's rights.

Moody, David Kennon.
Aids and rape: the constitutional dimensions of mandatory testing of sex offenders.
Cornell law review, v. 76, Nov. 1990: 238-267. LRS90-12792
"This Note examines the constitutionality of the California and New York statutes by considering whether a mandatory test for AIDS is reasonable in light of the fourth amendment, and whether disclosure of AIDS test results violates the accused's right to privacy."

O'Brien, Raymond C.
AIDS: perspective on the American family.
Villanova law review, v. 34, Apr. 1989: 209-279. LRS89-6251
This article focuses "on the probable impact of AIDS upon family law and family issues in America." Contends that AIDS will restrict "the societal demand and acceptance of new definitions of family."

Peterson, Lyle R. White, Carol R.
Premarital screening for antibodies to human immunodeficiency virus Type 1 in the United States.
American journal of public health, v. 80, Sept. 1990:1087-1094. LRS90-8374
"To evaluate premarital human immunodeficiency virus (HIV) screening as an approach to AIDS prevention in the United States, we determined HIV antibody seroprevalence in marriage license applicants in eight areas by blinded testing of blood specimens routinely collected for syphilis serology . . . We also examined the impact of mandatory premarital HIV screening on marriage rates in Louisiana and Illinois.... Conclude that compared with other HIV prevention programs mandatory premarital screening would be expensive and would probably have a minor impact on the HIV epidemic."

Richardson, Diane.
Women and AIDS.
New York, Methuen, 1988. 183 p. RC607.A26R53
Provides an informative account of the issues AIDS raises for women. Inquires into the racism, sexism, and homophobia surrounding AIDS. Examines how women are more likely to be discriminated against in terms of receiving AIDS health care. Outlines the economic problems faced by single mothers who contract AIDS.

Schepard, Andrew.
AIDS and divorce.
Family law quarterly, v. 23, spring 1989: 1-42. LRS89-12259
"A narrow purpose of this article is to preliminarily explore the impact of AIDS on divorce law: the grounds for divorce, discovery, property distribution, maintenance, child support, custody and pretrial procedure. The article's aim, however, is broader than simply analyzing and applying legal doctrine. By analyzing the impact of AIDS on divorce, it seeks to highlight fundamental questions about the purposes of divorce law and procedure."

Turnock, Bernard J. Kelly, Chester J.
Mandatory premarital testing for human immunodeficiency virus: the Illinois experience.
JAMA [Journal of the American Medical Association], v. 261, June 16, 1989: 3415-3418. LRS89-5535
Concludes that mandatory premarital testing is not a cost-effective method for controlling HIV infection. "During the first 6 months of legislatively mandated premarital testing for human immunodeficiency virus in Illinois, 8 of 70,846 applicants for marriage licenses were found to be seropositive, yielding a seroprevalence of 0.011%. The total costs of the testing program for 6 months is estimated at $2.5 million or $312,000 per seropositive individual identified."

Women + AIDS.
Ms., v. 1, Jan.-Feb. 1991: 16-33. LRS91-2190
Contents. --HIV: the global crisis, by Marcia Ann Gillespie. - -HIV: the national scandal, by Peg Byron. Articles discuss the latest developments and examine the potential impact both internationally and in the U.S. Accompanying article contains testimonies of caregivers and patients.

Education and Prevention

Amer-Hirsch, Wendy.
Educating youth about AIDS: a model program.
Children today, v. 18, Sept.-Oct. 1989:16-19. LRS89-11573
Profiles the AIDS Awareness Workshops sponsored by the Girls Club of New York.

Bellis, David J.
Fear of AIDS and risk reduction among heroin-addicted female street prostitutes: personal interviews with 72 Southern California subjects.
Journal of alcohol and drug education, v. 35, spring 1990: 26-37. LRS90-2742
"Seventy-two heroin-addicted Southern California female street prostitutes were interviewed in their usual environment. Though knowledgeable about and fearful of AIDS, they had not changed their sexual or drug use behavior. Specifically, they did nothing to protect themselves or their customers from HIV infection by abstaining from heroin, by relying on disinfected and unshared injection equipment, or by requiring condom use." Calls for needle-exchange program, expansion of methadone maintenance treatment program, and of street risk reduction education programs for intravenous drug abuses.

Block, Adam.
The house wife and the renegades.
California magazine, v. 16, Jan. 1991: 66-71, 99-100. LRS91-1312
Profiles Natalie Silva, a housewife from Sparks, Nevada, who was infected with HIV from her bisexual husband. Silva won a settlement against her husband's estate for his negligence. She has worked with Project Inform, a group that tries to find pharmaceuticals that could help AIDS patients, and she has become a spokeswoman for women with AIDS.

Chavkin, Wendy.
Preventing AIDS, targeting women.
Health/PAC bulletin, v. 20, spring 1990: 19-23. LRS90-4009
"Efforts to insert AIDS prevention activities in the context of pregnancy and heterosexual sex inevitably raise issues of women's subservience and empowerment. Because reproduction has been centrally linked to the limitation of opportunities for women, attempts to change behavior in this arena can only succeed if designed with history and culture in mind. Efforts to protect women and infants have to be linked with concrete services so as to genuinely expand reproductive choice."

Davis-Berman, Jennifer. Brown, Debra.
AIDS knowledge and risky behavior by incarcerated females: IV and non-IV drug users.
Sociology and social research, v. 75, Oct. 1990: 8-16. LRS90-11265
"One hundred and nine incarcerated females are surveyed on their knowledge about Acquired Immune Deficiency Syndrome and their participation in AIDS related high risk behaviors. Results are analyzed for the entire sample, and a comparison of intravenous (IV) and non-intravenous (non-IV) drug users is presented. Both groups report high levels of knowledge, yet there is no significant relationship between knowledge and behavior in either group."

Howe, Edmund G.
Societal and clinical approaches to preventing pediatric AIDS: some ethical considerations.
AIDS & public policy journal, v. 5, winter 1990: 9-16. LRS90-8370
Notes that children are the fastest growing group of AIDS patients in the United States. "Since approximately three-quarters of children with HIV acquire it perinatally, logical approaches to prevent pediatric AIDS would be to help women of childbearing age to avoid infection, to advise infected women of the risks to themselves and their fetuses if they become pregnant, and to discuss with infected pregnant women the option of terminating their pregnancies."

Kaplan, Helen Singer.
The real truth about women and AIDS: how to eliminate the risks without giving up love and sex.
New York, Simon & Schuster, c1987. 192 p. RC607 A26K37
"A Fireside Book". The author warns that heterosexual transmission of AIDS to women is increasing rapidly and that American women are being "victimized by inaccurate information". The author seeks to dispel these inaccuracies by providing information on the transmission and prevention of AIDS.

Norwood, Chris.
Advice for life: a woman's guide to AIDS risk and prevention.
New York, Pantheon Books, c1987. 178 p. RC607.A26N67
"A National Women's Health Network guide." The author contends that "when the history of AIDS in the United States is finally written, it may be remembered above all that women were deceived. Science has never given us any reason to think that a virus--insensible and unknowing--would confine itself to predominantly male risk groups. In Central Africa, equal numbers of men and women have been infected since the disease was first recognized there. That, in itself, was a severe warning. Even though AIDS, in the West, first infected largely male populations of homosexuals, bisexuals, drug addicts, and hemophiliacs, it always was a sexually transmitted disease that could be expected to spread to women."

Patton, Cindy.
Making it: a woman's guide to sex in the age of AIDS.
Ithaca, N.Y., Firebrand Books, c1987. 53 p. HQ46.P28

The Relationship between women's attitudes about condoms and their use: implications for condom promotion programs.
American journal of public health, v. 79, Apr. 1989: 499-503. LRS89-1532
"A survey of 759 women attending contraceptive care clinics revealed that a majority of women endorsed condom use as an important way to reduce the spread of AIDS (acquired immunodeficiency syndrome); 82 per cent reported past use of condoms, but only 14 per cent reported using condoms in addition to another form of contraception to prevent infection with sexually transmitted pathogens."

Stein, Zena A.
HIV prevention: the need for methods women can use.
American journal of public health, v. 80, Apr. 1990: 460-462. LRS90-1995
"Little attention has been given to barriers to HIV transmission that depend on the woman and are under her control. Tactics which interrupt transmission of the virus should be considered in.