INTRODUCTION: Previous studies suggest that women may present later in the course of HIV infection and demonstrate more rapid clinical progression than men. This observation may reflect a delay in addressing the HIV epidemic among women. OBJECTIVES: To determine if gender-related differences in clinical stage of presentation and survival exist among HIV-infected individuals who receive treatment at the Comprehensive AIDS Center (CAC) of Northwestern Univ. METHODS: The outpatient records of all HIV-infected women who presented to the CAC for care from 1/87-12/92 were reviewed (N = 137). Demographic data, risk factors, methods of referral, clinical stage and CD4 count at presentation, duration of followup, and clinical outcome were recorded. A random control group of HIV-infected men treated during the same time period was similarly evaluated (N = 125). The data was analyzed to assess possible gender-related differences between the two groups. RESULTS: Demographic analysis revealed a greater proportion of racial minorities among women Chi-square; p = .001). A greater proportion of females reported a history of IVDU (p = .020). Despite these differences, women consistently presented with higher absolute CD4 cell counts than men (p = .068), and were more likely to be asymptomatic at presentation (p = .002). When comparing mortality rates over time median survival for females was longer (female = 16 months; male = 12 months). However, when controlled for CD4 count, this difference was not significant. CONCLUSIONS: Contrary to other reports, women studied at our center presented earlier in the course of their illness and had similar survival rates as male patients. Women may have presented earlier to our center because they were more likely than men to use it as their initial site of HIV care. Gender differences observed most likely reflect variations in utilization and method of referral rather than biologic differences.

*HIV Infections/ETIOLOGY

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