Statement of Anthony S. Fauci, M.D. Director, National Institute of Allergy and Infectious Diseases, National Institutes of Health, on National Women and Girls HIV/AIDS Awaren...
As we commemorate the fifth annual National Women and Girls HIV/AIDS Awareness Day, we are reminded that in the United States, women and teenage girls accounted for more than a quarter of all new HIV/AIDS diagnoses in 2007 and more than 93,900 cumulative deaths from AIDS. Black women in this country suffer disproportionately from the HIV/AIDS epidemic, as they acquire new HIV infections at nearly 15 times the rate of white women. Worldwide, half of the estimated 33.4 million people living with HIV in 2008 were female, and HIV was the leading cause of disease and death for women of childbearing age.
Women and girls can take a critical step toward maintaining their health by getting tested for HIV during routine medical care, as the Centers for Disease Control and Prevention and the American College of Physicians recommend. The early diagnosis and prompt treatment of HIV infection help prevent the destructive impact of the virus on the immune system and contribute to the prolongation of life. In addition, a woman's chance of transmitting HIV to others is lessened by treatment of her infection. The testing of pregnant women for the virus and the administration of antiretroviral drugs to prevent HIV transmission from mother to child have nearly eliminated perinatal HIV infection in the United States, although mother-to-child HIV transmission remains a major challenge in other parts of the world.
Women and teenage girls most often acquire HIV through sex with an infected male partner. For many women and girls, especially those in abusive relationships or commercial sex work, it may be difficult or impossible to negotiate condom use or refuse demands for sex. This power imbalance in sexual relationships must be remedied. Meanwhile, we at the National Institute of Allergy and Infectious Diseases (NIAID), part of NIH, place a priority on developing HIV prevention tools that women and adolescent girls can use independently and proactively. For example, NIAID-funded scientists are working to develop an effective microbicide — a gel, cream or foam intended to prevent the sexual transmission of HIV when applied topically inside the vagina or rectum. NIAID-sponsored researchers also are evaluating an experimental approach known as pre-exposure prophylaxis (PrEP) to see whether the use of an antiretroviral drug regimen protects individuals from HIV infection. A large NIAID study is testing the safety and efficacy of both a microbicide and PrEP in women and assessing whether one approach is preferable to the other (http://www3.niaid.nih.gov/news/newsreleases/2009/VOICE.htm).
While prevention is key to ending the HIV/AIDS epidemic, it is equally important to optimize care for women infected with the virus. NIAID is a major sponsor of the Women's Interagency Health Study, which has been researching the impact of HIV infection on women in the United States for more than 16 years (http://statepiaps.jhsph.edu/wihs/). The institute recently launched a study that will determine whether HIV-infected women who do not yet need HIV treatment according to current guidelines, but begin a three-antiretroviral-drug regimen during pregnancy and breastfeeding to prevent transmitting the virus to their babies, are better off continuing to take the drugs after cessation of breastfeeding, rather than discontinuing them (http://www3.niaid.nih.gov/news/newsreleases/2010/PROMISE.htm).
Many American women and girls face barriers to HIV prevention and care that may seem insurmountable. Some of these individuals live in inner city, impoverished, largely minority neighborhoods and are at high risk for HIV infection. NIAID is conducting a study to learn how to deliver urgently needed HIV prevention and treatment services to this hard-to-reach group. (http://clinicaltrials.gov/ct2/show/NCT00995176).
HIV/AIDS poses a threat to the health of women and girls nationally and globally. NIAID is committed to supporting research to develop HIV prevention tools that women and girls can control and to providing HIV prevention and care to the most vulnerable members of this group. I encourage women and adolescent girls to take advantage of routine HIV testing and, if infected, to start treatment as early as their doctors recommend. The observance of National Women and Girls HIV/AIDS Awareness Day marks an opportunity for all of us to consider what we can do to curb the spread of HIV among women and teenage girls, whether that means ourselves or female partners, relatives and friends.
Dr. Fauci is director of the National Institute of Allergy and Infectious Diseases at the National Institutes of Health in Bethesda, Maryland.
Each year, the NIH Office of AIDS Research (http://www.oar.nih.gov/) produces a Trans-NIH Plan for HIV-Related Research that identifies strategic priorities for all areas of HIV/AIDS research. The plan is developed in collaboration with experts from the NIH institutes and centers, other government agencies, non-governmental organizations and HIV/AIDS community representatives. The Fiscal Year 2011 Trans-NIH Plan for HIV-Related Research contains a chapter specifically devoted to research addressing HIV/AIDS in special populations, including women and girls (http://www.oar.nih.gov/strategicplan/fy2011/index.asp).
For more information about HIV/AIDS, please visit www.aids.gov and NIAID's HIV/AIDS portal (http://www3.niaid.nih.gov/topics/HIVAIDS/). To volunteer for an HIV/AIDS clinical trial, go to http://www.clinicaltrials.gov/ct2/results?term=HIV&recr=Open.
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NIAID conducts and supports research — at NIH, throughout the United States, and worldwide — to study the causes of infectious and immune-mediated diseases, and to develop better means of preventing, diagnosing and treating these illnesses. News releases, fact sheets and other NIAID-related materials are available on the NIAID Web site at http://www.niaid.nih.gov.