HIV INFECTION FASTER FOR WOMEN

The study is the second in the world to record a faster rate among female
injection drug users than males and is the first to show it as a sustained
trend.

TORONTO -- Women who inject drugs in Vancouver are becoming infected with
HIV at a startlingly faster rate -- 42 per cent -- than the men they share
time, needles and sex with, the latest findings out of a landmark study of
drug users show.

Furthermore, the factors that put these women at risk are different from
those influencing the HIV status of men, a reality that poses challenges
for public health officials trying to curb the spread of the deadly virus.

"The problem is very different between women and men," said Dr. Patricia
Spittal, lead author of the article, published today in the Canadian
Medical Association Journal.

"It's about power, it's about pain. It's about rape. It's about not having
control over your sexual life or your injection life."

The findings are drawn from the Vancouver Injection Drug Users Study, which
tracks the lives and the health of drug users in the city's Downtown
Eastside, the largest community of injection drug users in the country. The
study, which began in May 1996, is supported by a grant from the U.S.
National Institutes of Health.

The Vancouver study is only the second in the world to record a faster
infection rate among female injection drug users than males and is the
first to show it as a sustained trend.

Generally, men who inject drugs acquire the virus at a much quicker pace
than women -- but not in Vancouver, said Dr. Martin Schechter, senior
author of the paper.

"It's a persistent difference. It doesn't appear to be going away."

A major part of the problem appears to be the power relationships between
the women caught in the vortex of injection drug use and their intimate
partners, say the researchers, who work at the University of British
Columbia, the B.C. Centre for Excellence in HIV/AIDS and St. Paul's
Hospital in Vancouver.

Many share needles with their sex partners, even though they know the risk.

Some agree to be "second on the needle" because they are essentially in
thrall; their partner, who may also be their pimp, holds the money and buys
the drugs.

"Sex and the needle are very intricate issues," Spittal said. "It's about
control and it's about intimacy and it's about power.

"Negotiating safe needle use is like negotiating safe condom use. It's
about trust. And sometimes, as you know, in different kinds of
relationships, it's very emotionally difficult for women to have control
over safe needle and safe sex."

About 70 per cent of the women in the study have been sexually abused and
an equal number are in the sex trade, Spittal noted.

Some women tell the researchers they agree to be second on the needle
because they love their partners. Others admit to being so "drug sick" --
in need of a fix -- that they'd go along with any demand made of them in
order to get a hit.

Some women, especially those new to injection drugs, don't know how to
inject themselves and need help getting a fix.

Men, too, can be injection dependent, but women are more likely to need
help injecting, Schechter said.

"And often the person who needs help injecting will be second on the needle
as well."

These women may later learn how to inject themselves, but by then they may
not need to worry about being second on a needle.

The fact some women have little control over drug preparation and the
injection process will make it difficult to tailor programs to reduce the
dangers, the authors admitted.

Safe injection sites would help, Spittal suggested, as would more drug
treatment slots for reserved for women.

"Female injectors are really vulnerable and it's an issue that's been
neglected in Canada."

But Schechter believes the lesson taught by the trail of the AIDS virus is
that Bandaid solutions will only offer limited relief.

Society needs to find solutions to the problems of poverty, homelessness
and abuse, the factors that make people most vulnerable to HIV in the first
place, he said from Vancouver.

"HIV has a very uncanny ability to seek out the marginalized people," he
said. "Even in a country like Canada, we now see the epidemic moving into
inner cities, injection drug users, marginalized populations, street
youths, the homeless, aboriginals and prison populations."

These numbers show that even within vulnerable populations the virus will
hone in on the weakest, those with the least power, Schechter added.

"And what this shows is that even within the context of the Downtown
Eastside of Vancouver, the virus has the ability to go into women, who are
more marginalized than the men."