Yes, women can get HIV and develop AIDS. In 2023, women accounted for 19% of all new HIV diagnoses in the United States, totaling about 7,350 cases. Women are actually more biologically vulnerable to HIV infection than men during heterosexual sex, and the virus can cause health complications in women that differ from those seen in men.
How HIV and AIDS Differ
HIV is the virus. AIDS is the late stage of infection that develops when the immune system has been severely damaged. Specifically, AIDS is diagnosed when a type of immune cell called CD4 cells drops below 200 per cubic millimeter of blood. A healthy person typically has between 500 and 1,500. Without treatment, HIV gradually destroys these cells over a period of years, eventually leaving the body unable to fight off infections and cancers it would normally handle easily.
With modern treatment, most people with HIV never develop AIDS. Medications can keep the virus suppressed indefinitely, preserving immune function for a normal lifespan.
Why Women Are Biologically Vulnerable
During vaginal sex, the receptive partner faces a higher transmission risk than the insertive partner. The estimated risk of HIV transmission per act of unprotected sex with an untreated partner is about 14 in 10,000 for the receptive partner. That number sounds small for a single encounter, but it accumulates with repeated exposure.
The female reproductive tract has structural features that increase susceptibility. The vagina and outer cervix are lined with multiple layers of tissue that provide a reasonable barrier, but the inner cervix is covered by only a single, fragile layer. This thinner tissue is more easily penetrated by the virus. Hormonal shifts during the menstrual cycle add another layer of vulnerability. Around ovulation, the number of cells that HIV targets increases in the upper reproductive tract. After ovulation, immune defenses in the uterus are temporarily suppressed to allow for potential pregnancy, which can create a more permissive environment for the virus to establish infection.
Other factors that increase risk for women include sexually transmitted infections (which cause inflammation and micro-tears in tissue), vaginal douching, and having a partner who does not know their HIV status.
Symptoms That Are Different in Women
Early HIV infection often causes flu-like symptoms in both men and women: fever, fatigue, swollen lymph nodes, sore throat. These appear two to four weeks after exposure and then resolve, sometimes leading people to assume they had a routine illness.
As the infection progresses, women experience several complications that men do not. These include repeated vaginal yeast infections, bacterial vaginosis, and severe pelvic inflammatory disease. Women with HIV also face a higher risk of cervical cancer and may experience menstrual cycle irregularities. Over the long term, HIV-positive women have elevated rates of osteoporosis and heart disease, particularly heart attacks. Some women enter menopause earlier or have more severe symptoms like hot flashes. These differences mean that HIV management in women sometimes requires attention to reproductive and gynecological health alongside standard antiviral treatment.
How Women Contract HIV
The most common route of transmission for women is vaginal sex with an HIV-positive partner. Other routes include anal sex (which carries a higher per-act risk than vaginal sex), sharing needles for drug injection, and less commonly, oral sex. HIV can also pass from mother to child during pregnancy, childbirth, or breastfeeding.
HIV is not transmitted through casual contact, sharing food or drinks, hugging, kissing, toilet seats, or mosquito bites.
The Global Picture
In some parts of the world, women bear the heaviest burden of HIV. In sub-Saharan Africa, adolescent girls and young women aged 15 to 24 represent just 10% of the population but accounted for 25% of all new HIV infections globally in 2017. Among adolescents in the region, 80% of infections occur in girls aged 15 to 19. Young women in southern Africa are six times more likely to acquire HIV than young men of the same age. These disparities are driven by a combination of biological vulnerability, gender inequality, limited access to prevention tools, and partnerships with older men who have higher rates of infection.
Prevention Options for Women
Condoms remain one of the most effective barriers against HIV when used consistently. But women now have additional tools. Pre-exposure prophylaxis, known as PrEP, is a daily pill that prevents HIV infection. For vaginal sex, PrEP reaches maximum protection after about 21 days of daily use. Adherence is critical: taking it inconsistently leaves gaps in protection.
If a partner is living with HIV, there is strong reason for reassurance. A person on effective treatment who maintains an undetectable viral load has zero risk of transmitting the virus sexually. This principle, confirmed in large clinical studies, is known as Undetectable = Untransmittable, or U=U. When treatment is taken as prescribed, the amount of virus in the blood drops so low that standard tests cannot detect it, and transmission simply does not occur.
Pregnancy and HIV
Women with HIV can have healthy pregnancies and healthy babies. Without treatment, the virus can pass to the baby during pregnancy, labor, delivery, or breastfeeding. With consistent antiretroviral treatment throughout pregnancy and childbirth, the risk of transmitting HIV to the baby drops to less than 1%. Maintaining an undetectable viral load during pregnancy and breastfeeding is the key factor.
Current guidelines recommend HIV testing early in every pregnancy. Women at higher risk, such as those with a new sexual partner during pregnancy or those living in areas with higher HIV rates, are recommended for repeat testing in the third trimester.
Testing Recommendations
Everyone between the ages of 13 and 64 should be tested for HIV at least once as part of routine health care. If you have ongoing risk factors, such as a new partner, multiple partners, a partner whose status you don’t know, or shared injection equipment, annual testing is recommended. Modern HIV tests can detect infection within a few weeks of exposure, and many clinics offer rapid tests with results in under 30 minutes.
Early detection makes a significant difference. Starting treatment promptly preserves immune function, prevents progression to AIDS, and eliminates the risk of passing the virus to sexual partners or, during pregnancy, to a baby.