207942 Sex differences in disease severity among HIV-infected adults in Ghana

Tuesday, November 10, 2009

Francis A. Obuseh, DrPH, MPH, MS , Public Health Division, 436th Aerospace Medicine Squadron, United States Air Force, Dover, DE
Andrzej Kulczycki, PhD , Department of Maternal and Child Health, The University of Alabama at Birmingham, Birmingham, AL
John E. Ehiri, PhD; MPH , School of Public Health, University of Alabama at Birmingham, Birmingham, AL
John Waterbor, MD , Department of Epidemiology, School of Public Health, Birmingham, AL
Pauline Jolly, PhD, MPH , Department of Epidemiology, University of Alabama at Birmingham, Birmingham, AL

There are evidence of increased rates of infection and disease progression among HIV patients in Ghana. Social and biological vulnerability have been shown to be important predictors of HIV infection, disease progression, and survival. However, it is unclear whether these differences are mediated by sex/ gender disparities in this population.


We conducted a cross-sectional survey to determine the relationship between sex, micronutrient, immune parameters and HIV progression among group of 105 women and 53 men living in Ghana. We explored relationship using chi-square and logistic regression.


There were sex differences in some social determinants, women were more likely to be less educated and have low income. Women had higher CD4 counts than men did (323.9 cells/ěl versus 278.3±193.8 cells/ěl) and had lower viral load (8.2 copies/ml versus 8.7 copies/ml). They were 3 times more likely to have low viral load but progress to AIDS at the same rate as men. There were no significant sex differences in disease progression based on CD4 counts; however, nutritional analysis by stages of HIV showed that in comparison with men, women with advanced-disease CD4 count stages had a marginal deficiency of vitamin A (p=0.06).


Although women were more likely to have lower viral load, rate of progression did not differ in both groups. Women with the advanced staged of the HIV were also more malnourished in vitamin A. Potential implication of our study results should influence the nutritional management and eligibility of antiretroviral treatment in women.

Learning Objectives:
1. Assess the effect of sex/ gender in HIV disease severity and progression. 2. Identify the ways in which characteristics, behaviors, or circumstances related to sex are associated with increased prevalence of HIV and disease severity or progression. 3. Identify potential implication in the nutritional management, immune status and eligibility of antiretroviral treatment in women with HIV.

Keywords: Women and HIV/AIDS, HIV Interventions

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: DrPH, Public Health/ Maternal and Child Health MPH, Epidemiology/ International Health
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.