FEMALE DRUG ADDICTS TWICE AS LIKELY TO GET AIDS AS MEN

Downtown Eastside rate a first in developed world

Female drug addicts in Vancouver's Downtown Eastside are becoming infected
with the virus that causes AIDS at a rate more than 50 per cent higher than
drug-using men, according to a new study.

The study, by researchers at B.C.'s Centre for Excellence in HIV/AIDS, is
the first to show a group in the developed world with a higher rate of
infection for women than men.

"In most other cities, when you compare male and female [drug users], the
infection rates in men are usually higher," said Martin Schechter, a local
AIDS researcher and one of the authors of the study. "These are people
living side-by-side in the same neighbourhood. So for [women] to have a
50-per-cent higher rate of infection -- we find that quite alarming."

Before this study, the only parts of the world with higher rates of
infection for women than men were developing countries in places such as
Africa and Southeast Asia.

The study's authors, and outreach workers on the Downtown Eastside, say
women's high rates of infection are likely due to their involvement in the
sex trade and a lack of power in their relationships with male partners
that make it difficult for them to insist on safe sexual practices and
clean needles.

The findings are part of the Vancouver Injection Drug Users Study (VIDUS),
a long-term study of 1,400 heroin and cocaine users in the Downtown Eastside.

Researchers found that, since May 1996, 17 per cent of the uninfected women
in their study became infected with the human immunodeficiency virus
compared to only 11 per cent of the men.

Maria Hudspith is program coordinator for the Positive Women's Network, an
organization that provides support to HIV-infected women.

In Vancouver's most vulnerable neighbourhood, she said, female drug users
are perhaps the most vulnerable group.

"Many johns will pay more for sex without a condom," Hudspith said -- and
women desperate for drugs, shelter or food sometimes value the short-term
need for money over the hypothetical risk of infection.

Schechter said 58 per cent of the women in the study said they had traded
sex for money or drugs, compared to just 10 per cent of men.

"In vulnerable situations, it's almost impossible for women to negotiate
the use of condoms," Schechter said.

And while unsafe sex is risky for both partners, research has shown
male-to-female HIV transmission is far more common than female-to-male
transmission, Schechter said.

Patricia Spittal, the lead author of the study, said female drug users not
only practiced unsafe sex with tricks, they were also pressured to engage
in unsafe sex and needle-sharing with their male partners.

"It's basically intimacy that's killing these women," Spittal said.

If their high rate of infection were not cause enough for concern, past
research has also shown that when women on the Downtown Eastside do get
HIV, they are far less likely to receive proper treatment.

A study two years ago by the Centre for Excellence found less than half the
injection drug users with HIV in Vancouver were being treated with the new,
potentially life-saving "drug cocktail" therapy -- compared to 70 to 80 per
cent of gay men with HIV, and other infected groups. That study also found
female drug users were more than 2 1/2 times less likely to be on the drug
cocktail than male drug users.

And Schechter said women still appear to be receiving treatment at a far
lower rate than men.

Outreach workers say one of the ways to reduce infection rates among
drug-using women is to provide more services -- such as counselling and
housing -- to help women leave abusive and unhealthy relationships.

The study of female infection rates was carried out in part by the Urban
Health Research group at St. Paul's Hospital, which was launched last month
to conduct research on why disadvantaged groups in Vancouver are at more
risk of infection and illness.

The study has been submitted for publication in an international
AIDS-research journal.