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that causes the disease Kaposi's Sarcoma (KS).  Women do not have as much KS as men and we don't know exactly why.  But, the virus (a herpes virus) is a very interesting one because it has an impact on many different immunologic functions.  We will be looking at how the virus is shed, how it spreads, and try to make a better assessment of it, so that we may predict how women might end up having KS, or be at increased risk for KS.  This study will be done in conjunction with the Oral AIDS Group. 

The last sub-study is under the direction of Dr. Kathleen Clannon.  This sub-study will survey medical providers and see if the providers are able to determine who is really going to take their medicines.  For example, one thing that I have seen a lot in the medical literature, is that drug users aren't going to be able to take their medicines as directed.  However, the opposite was true.  In fact the very first studies showed that drug users can be quite capable of taking their medicines as directed.  So we want to make sure that people aren't making these decisions on the wrong basis. 

Moher:  What results have come out of the WIHS study

that participants might want to know about?

Ruth:  There are interesting results.  One study compared depression among women with HIV infection to women without HIV.  This study accounted for poverty, drug use, domestic violence, stress factors, and showed that depression among HIV positive women was not that much greater compared to women without HIV infection.  The message here is not that depression is not a problem for women living with HIV, but rather that the social issues, and the economic issues are so pervasive that if you're poor and living under difficult circumstances, these can be powerful contributing factors to one's depression. 

A study I've done looked at STD's in the participants and found that once women are aware of their HIV infection, the get fewer STD's than HIV negative women by reducing risky sexual behavior.  But still there is a third of both HIV infected and uninfected women that remain very sexually active and at some risk. 

Another study done in the WIHS looked at bacterial vaginosis (BV), the kind of vaginitis that gives you a smelly discharge.  They found that HIV uninfected women were more likely to have BV than HIV

positive women, perhaps because they had higher risk behaviors.  Gonorrhea and chylamidia was very uncommon in both HIV positive and HIV negative women in the study. 

The death rate has varied quite a bit from site to site in the WIHS and that's currently being looked at. We do know that the causes of death differ from site to site, and some sites enrolled women with more advanced disease. 

A history of domestic violence has been very common in the WIHS cohort.  Many women reported domestic violence situations in childhood or earlier in adulthood or in association after their HIV. The domestic violence rates were somewhat higher in the HIV-infected women.

Moher:  If you could change anything in the study, what would you change?

Ruth:  Well, I would have liked to have been able to recruit more people into the study. 

Moher:  NIH did not approve money to recruit new people?

Ruth:  No, frankly they

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