Gender differences in response to HIV infection.

There is strong epidemiologic evidence from studies of i.v. drug users in New York City for the existence of one or more gender-related cofactors in response to HIV infection. The strength of the evidence comes from the variety of data sets that indicate a gender-related cofactor and from the consistency of the pattern found: in all of the data sets, females appear to have a more "favorable" response than do males. The extent of underrepresentation of females in the cases of AIDS in i.v. drug users--a possible 35% reduction in the development of clinical AIDS-suggests that such a cofactor should be considered of practical importance. Identifying the mechanism(s) for a gender difference may lead to ways of deliberately affecting the course of the infection. Further research on the gender difference may also contribute to our understanding of interactions among the various components of the immune system and the interaction of the immune system with other behavioral and physiologic systems.