by Dr. Zeda F. Rosenberg
As we consider how to reach the end of HIV/AIDS, we must recognize that doing so will require giving women new ways to protect themselves against the virus.
Women are especially vulnerable to HIV because a combination of biology and gender inequities renders them more susceptible to infection than men. In sub-Saharan Africa, HIV is as at least two times more prevalent in young women ages 15 to 24 than in young men, partly because women lack effective and discreet tools they can use on their own to protect themselves.
As UNAIDS has recently highlighted, current prevention strategies are not decreasing the rate of new HIV infections quickly enough to end the epidemic -- and women and girls are especially at risk. Given recent advances in HIV prevention science, we can, and must, do better. Helping women to stay healthy and HIV-free would not only give them opportunities to thrive, but also promote the sustainable development of communities and societies.
The Promise of the Ring
This World AIDS Day, we have reason to believe that we can help realize that vision. Earlier this year, a long-acting vaginal ring was shown to safely help reduce women's HIV risk in two large Phase III clinical trials. Developed by my organization, the International Partnership for Microbicides, the self-inserted ring slowly releases an antiretroviral (ARV) drug called dapivirine.
The product is currently being used by former Phase III participants in two open-label studies across Africa, which will help us understand how the ring could fit into women's lives in the "real world." We are also pursuing regulatory approval (watch this video for more on the ring and next steps). But no single product will end the HIV epidemic -- the only realistic solution is to offer multiple options that meet women's needs, which change throughout their lives.
That is why investing in a range of new and different HIV prevention technologies is needed to slow the global epidemic -- from the monthly dapivirine ring to daily oral ARV pills known as PrEP and one day, a long-acting injectable drug and a vaccine. Only by slowing the epidemic can we achieve the Sustainable Development Goals (SDGs) -- a universal call to action to build a healthier, more prosperous and peaceful world.
Investing in a Sustainable Future
Here are five key SDGs we could advance by increasing investment in HIV prevention R&D and product roll-out for women:
- SDG 1: End poverty in all its forms everywhere. Households affected by HIV are more vulnerable to poverty. By reducing the number of HIV infections, we can reduce illness-related poverty, keep families strong and grow communities.
- SDG 3: Ensure healthy lives and promote well-being for all at all ages. New HIV prevention technologies would help reduce the burden of HIV/AIDS and improve the health and well-being of women and families.
- SDG 4: Ensure inclusive and equitable quality education and promote lifelong learning opportunities for all. New and practical HIV prevention options would help girls and young women stay in school and improve their chances for employment later.
- SDG 5: Achieve gender equality and empower all women and girls. New female-initiated HIV prevention products are a crucial part of a rights-based toolkit that will empower women and girls to protect their own well-being.
- SDG 6: Promote sustained, inclusive and sustainable economic growth, full and productive employment and decent work for all. New HIV prevention tools for women would lower HIV infection rates, allow healthy women to pursue employment, and help sustain strong and productive workforces.
World AIDS Day is a time to celebrate progress and marshal energy for the challenges we have yet to overcome. Today, we are more committed than ever to a future where women have the options they need to stay healthy, and to a more sustainable and inclusive world for all.
Dr. Zeda Rosenberg is the founding chief executive officer of the International Partnership for Microbicides (IPM), a nonprofit product development partnership established in 2002 to prevent HIV transmission by accelerating the development and availability of safe and effective microbicides for women in developing countries.
This blog is part of the blog series: Barometer Rising: No time to backtrack the fast track to ending HIV as a global health threat by 2030 by the Interagency Coalition on AIDS and Development (ICAD) in recognition of World AIDS Day (1 December). The series features a selection of blogs written by our member and partner organizations. Contributors share their broad range of perspectives and insight on what they think needs to be done to strengthen our HIV prevention efforts at home and abroad in order for the world to meet the ambitious target of ending AIDS as an epidemic by 2030.
Disclaimer: The views and opinions expressed in this blog series are those of the authors and do not necessarily reflect those of ICAD.
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Only one quarter of the 1.1 million people with HIV have their condition under control, where "under control" means the virus has been suppressed, according to a report released this summer by the Centers for Disease Control and Prevention. CORRECTION: The first sentence has been reworded to more accurately reflect the number of people with HIV.
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New HIV infection rates can be dramatically lowered by making antiretroviral drugs free, a study from Canadian researchers found. The Canadian Press reported on the study, conducted by B.C. Centre for Excellence in HIV-AIDS researchers, which showed that British Columbia -- a province that offers free access to antiretroviral therapy -- had the lowest rate of new HIV infections over a more-than-10-year period, compared with Ontairio and Quebec.
More than half of HIV-infected young people are unaware that they have the virus, according to a Centers for Disease Control and Prevention report. "Given everything we know about HIV and how to prevent it in 30 years of fighting the disease, it's just unacceptable that young people are becoming infected at such high rates," Reuters reported CDC Director Dr. Thomas Frieden saying. The report also showed that for young people, 72 percent of the new HIV infections were in men who have sex with men, while almost 50 percent were in young, African-American males, Reuters reported. These figures are based on 2010 data.
The number of people living with HIV has increased by 18 percent from 2001 to 2011, according to a report released this year from the United Nations Programme on AIDS. An estimated 34.2 million people around the world are living with HIV. The report also showed that deaths from AIDS have dropped, from 2.3 million in 2005-2006 to 1.7 million in 2011, Reuters reported.
According to the same United Nations report, costs for the cheapest UN-recommended antiretroviral therapy drugs have also decreased over the past 10 years, Reuters reported. A year's worth of the drugs used to cost $10,000 in 2000 for one person; now, it costs $100 a year.
The Food and Drug Administration this year officially approved the drug Truvada -- which has been used since 2004 as a treatment for HIV -- to be sold as a preventive measure for people who don't have the infection, but are at high risk for it. The FDA said that the pill should be considered for preventive use not only by gay or bisexual men who are at high risk for HIV, but also heterosexual men and women who may also face HIV risks, the Associated Press reported. Heterosexual men and women make up more than one-fourth of new cases of HIV, and "that's not a portion of the epidemic we want to ignore," the CDC's Dr. Dawn Smith, who was the lead author of the new recommendations, told the Associated Press. The FDA also approved a new drug this year, Stribild, to treat HIV, Reuters reported.
In findings published this year in the journal PLoS Pathogens, scientists from the University of California, Los Angeles found that it's possible to genetically engineer stem cells to attack living HIV-infected cells in mice. While the study was only for "proof-of-principle," it "lays the groundwork for the potential use of this type of an approach in combating HIV infection in infected individuals, in hopes of eradicating the virus from the body," study researcher Dr. Scott G. Kitchen, an assistant professor of medicine at UCLA, said in a statement.
People should be screened for HIV even if they're not at high risk of contracting the infection, according to draft recommendations released just last month by the U.S. Preventive Services Task Force. The recommendations would mean that everyone between the ages of 15 and 65 should be screened for HIV, even if they're not at high risk for it, Reuters reported. "The prior recommendations were for screening high-risk adults and adolescents," Dr. Douglas Owens, a member of the USPSTF task force and a Stanford University medical professor, told Reuters. "The current recommendation is for screening everyone, regardless of their risk."
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