As semen infected with HIV typically contains a higher concentration of virus than a woman’s sexual secretions this makes male-to-female transmission easier than female-to-men. Younger women are reported to be at an even greater biological risk because their physiologically immature cervix and scant vaginal secretions put up less of a barrier to HIV. There is evidence that women again become more vulnerable after the menopause.
In some parts of the world, men prefer sex when herbs are inserted to dry and tighten the vagina before intercourse. These substances can damage the delicate vaginal lining and make it easier for HIV to gain entry to a woman’s body.
Tearing and bleeding during intercourse, whether from ‘rough sex’, rape or prior genital mutilation (female circumcision) also multiplies the risk of HIV infections. Women also run a similar risk from unprotected anal intercourse which is opted for because it preserves virginity and avoids the risk of pregnancy. This form of sex often tears the delicate tissues and affords easy entry to the virus. (n.b. anal intercourse is eyed negatively by Islam).
Untreated Sexually Transmitted Disease (STD) in either partner also multiplies the risk of HIV transmission. Many STD cases in women go unrecognized because sores or related symptoms are absent or hard to see and because women, if they are monoga mous, do not suspect they are at risk.
Being biologically vulnerable does not however mean 'unprotectable'. Experience from the past decade proves that both men and women can be helped to avoid HIV. Infection rates can be lowered by screening blood for transfusion, by providing frank information about how HIV can spread, by clear prevention messages urging abstinence, fidelity or in the case of short-term marriages (mutah), safer sex by condom promotion.
The use of sterilised equipment in health care and the use of new blades when going for a hair cut are also crucial. Similarly exposed wounds should be bandaged to avoid unlikely but possibe cross-infection.
The problem for some women arises when their husbands have sexual relationships outside marriage. Because of socio-economic circumstances, women have little or no control over how and when such husbands have sex and hence remain vulnerable to being infected with HIV.
Whilst prostitution is derogatory and a major sin in Islam, sex workers in many countries have at least banded together to demand condoms from all clients or only work in brothels where Governments have instituted a "condoms-only" rule. Ironically, these women may enjoy more protection than housewives who have no way of ascertaining their husbands extra-marital sex and thus easily succumb to the request by their spouse to have sex without condoms.
Even a woman in a stable marriage relationship who is economically dependent on her partner but knows or suspects that her husband carries the virus may be compelled by circumstances not to jeopardize his support. She can probably compel her husband for safer sex or stop sexual relations but what she cannot do easily is to leave him either because of sentimental reasons pertaining to the children or because she has no means to support herself and has nowhere to go to.
At times there is again the possibility that the husband may have contracted the virus innocently.
Many young girls are brought up with little understanding of their reproductive system or the mechanics of HIV/STD transmission and prevention. It is important that girls are adequately enlightened because by being well aware of the risks involved they can take reasonable precautions rather than just sitting back and hoping for the best.
Condoms, the main safeguard against the spread of the HIV virus (though not full-proof) become a dilemma when couples want children. Couples wanting children need to know their HIV status and, if both are uninfected, should agree to remain faithful to each other and thereby refrain from unsafe extra-marital sex.
The obstacles however are that couples are often unwilling to discuss sex related issues openly and even prefer to stay away from counseling services. As a result STDs, which increases a woman’s biological vulnerability to HIV, often go untreated even when symptomatic.
Women are often brought up to accept ill health and ailments particularly related to women as being their lot in life and because sexually transmitted infections carry a heavy social stigma (less so for men), women tend to avoid STD clinics for fear of being recognised.
Very often the health workers to whom women do have access, in primary health or maternal and child health clinics, are also unsympathetic, judgemental and unprepared to diagnose and treat STDs. Women should remember that they all have only one life to live and it is a folly to sacrifice this preciopus gift from God out of undue fear in circumstances where more often than not they are not even to blame. Lets face it, its either protection or death!
Cardiologists are excited about the development because the drugs now seem to be emerging as ‘life saving" for heart patients with high cholesterol levels. Some pharmaceutical companies are reported to have already applied for the process patenting of the drug so that they can begin selling it.
The drugs have been found useful in preventing heart attacks in high-risk people and also preventing further blockage in arteries following a bypass surgery or angioplasty.
A Professor of Cardiology at the All India Institute of Medical Sciences, Dr. K. Srinath Reddy, says the drugs are more likely to be useful in people who have had a heart attack or have undergone bypass surgery.
In one trial, known as 4S, conducted in four countries, 4444 patients with heart ailments were monitored for 5.4 years. Compared to those in the placebo group, patients put on these drugs showed a 30 per cent reduction in risk of death from all causes and a 42 per cent risk reduction in death from coronary artery disease.
Cardiologists have found that the drug not only reduces risk of heart attacks but is also useful against diabetes and strokes. The drug has been found to reduce LDL Cholesterol, the harmful component, by 30 per cent in patients.
Cardiologists say this is the first time that a drug has been able to reduce cholesterol so dramatically. The relation of coronary artery disease to cholesterol, though discussed much earlier, has been proved recently through a 25 year study.
The study, conducted in seven countries across the world, has proved that as cholesterol levels increase, the risks of coronary heart disease increases proportionately.
Another study, known as the CARE study conducted in the United States, has also tested the efficacy of these drugs. The study put 1,000 patients on these drugs.
At the end of five years, the study concluded that the drugs had prevented 11 deaths due to heart attacks, 26 heart attacks, 25 coronary bypass surgeries, 37 angioplasties and 13 strokes.
Experts are however still debating its widespread use in context of the cost-effectiveness of the drugs. Analysts suggest that this therapy should be advocated in select high-risk patients who have either had a bypass surgery or an angioplasty or have suffered a heart attack.
Another view voiced by cardiologists is that the drugs save costs otherwise involved in a bypass surgery or an angioplasty. They say that the drug may prove more cost effective in the long ter reducing the need for surgeries for coronary artery disease. One dose of the drug is said to cost Rs 10 in India.
Findings of the study which suggested that exposure to second hand smoke can contribute to lung cancer deaths were published in the January, 1997 of a Cancer Journal. According to this journal, researchers analysed data from 114,286 female and 19,549 male never-smokers who had married to smokers and compared it with the data from 77,000 female and 77,000 male never-smokers whose spouse did not smoke.
The findings revealed that Lung Cancer death rates, adjusted for other factors such as age, race, diet and occupation are 20 percent higher among women whose husbands smoke compared with those married to non smokers.
In 1992,the US Environmental Protection Agency (EPA) also revealed similar findings and declared that second hand smoke is a human carcinogen.