Related: Women and HIV in America: Making AIDS History by By Susan J. Blumenthal, M.D., and Jennifer A. Sherwood, M.S.P.H via HuffingtonPost.com.
Her Excellency Jeannette Kagame, First Lady of Rwanda; Dr. Susan Blumenthal, amfAR Senior Policy and Medical Advisor; and Ambassador Deborah Birx, M.D., U.S. Global AIDS Coordinator (Photo: amfAR)
Women and girls constitute more than half of all people living with HIV globally and one in four HIV-positive Americans. Despite recent successes in treatment and prevention, a range of biological, social, cultural, and environmental factors continue to increase women’s vulnerability to HIV infection. Against this backdrop and to illuminate the work that remains to be done to achieve an AIDS-free generation for women and girls in the U.S. and around the world, amfAR held a Capitol Hill briefing, March 24, that drew leaders from government, academia, and the nonprofit sector.
“Although women were often neglected in terms of funding, research, and programmatic priorities at the start of the epidemic, recent years have brought stunning progress,” said Susan Blumenthal, M.D., conference chair and amfAR senior policy and medical advisor, who served as the country’s first Deputy Assistant Secretary for Women’s Health in the U.S. Department of Health and Human Services. Dr. Blumenthal cited a 25% reduction in HIV-related deaths among women globally between 2010 and 2013, a 49% decline in HIV diagnoses for American women from 2002–2011, and a 52% reduction in mother-to-child transmission (MTCT) of HIV globally since 2001, with virtual elimination of MTCT in the United States today.
“But it is fragile progress, and we are facing budget cuts,” she added. “HIV remains the leading cause of death for women of reproductive age worldwide. We are at a critical moment, and we have a decision to make—will we work together to marshal the political will and resources necessary to end the epidemic for everyone.”
U.S. Congresswoman Barbara Lee echoed this sentiment, stating, “We are at a defining moment, and it is so important to not think that just because there is no noise right now we have achieved an AIDS-free generation. It is critical we continue to push—88% of women living with HIV in the U.S. know their status, but only 32% have achieved viral suppression. We need to target our resources and ensure that our HIV/AIDS strategy is part of a plan for empowerment of women and economic development.”
Her Excellency Jeannette Kagame, First Lady of Rwanda, who co-founded the Organization of African First Ladies Against HIV/AIDS, described the success of Rwanda’s program to combat HIV among women by empowering them. The comprehensive response was developed as the nation emerged from the 1994 genocide, when “hundreds of thousands of women were brutally raped and infected with HIV.”
Today, the rate of MTCT is just 2% in Rwanda, which boasts the highest proportion of females in the national legislature worldwide, at 64%. “We were convinced that addressing the issue of women and HIV/AIDS, among other pressing matters we had to manage, would be more effective if we took a holistic approach—one that combined laws and policies with the implementation of various programs that favor women and girls,” she said. (Read her full remarks here.)
(Left to right) Dr. Vignetta Charles, Senior Vice President of AIDS United; Maria Cuomo Cole, Chairman of HELP USA; Deborah Derrick, President of Friends of the Global Fight Against AIDS, Tuberculosis and Malaria; and Regan Hofmann, UNAIDS Policy Officer and Member of amfAR’s Board of Trustees (Photo: Getty Images)
Maria Cuomo Cole, chairman of HELP USA, which provides housing and services for the homeless, called for a similar holistic approach in the U.S. “The progress amfAR and the community have made in treating HIV is overwhelming, but until the social determinants of HIV are addressed, it won’t be sustained,” said Cole. “Sixty percent of people living in poverty in the U.S. are women, and 65% of the homeless population are women and children.” Both poverty and homelessness greatly increase risk of HIV infection.
Ambassador Deborah Birx, M.D., U.S. Global AIDS Coordinator, and Douglas Brooks, director of the White House Office of National AIDS Policy, described how, on both the domestic and global levels, the U.S. is working to combat another factor that greatly elevates women’s risk of HIV infection—physical and sexual violence. More than one in three women worldwide have been the victims of violence.
Ambassador Birx also described the need for more research into targeted strategies that better respond to HIV among women, especially young women, ages 15–24, who globally have HIV infection rates twice as high as young men and account for 31% of all new HIV infections in sub-Saharan Africa. “We’re not sure what the best tools to reach young women are or what combination interventions for women looks like,” she said. “We need more research on young women and what it takes to keep them HIV negative.”
The program also addressed medical research aimed at improving HIV prevention for women. Dr. Sharon Hillier of the University of Pittsburgh School of Medicine described exciting progress on female-controlled HIV prevention methods, including vaginal rings containing antiretroviral (ARV) medicines that are currently undergoing clinical trials. Unlike a condom, women would control this method of HIV prevention, which could offer protection for up to three months. She also spoke of the need to develop prevention products that combine ARVs with contraceptives. “Women and girls must be able to protect themselves from HIV without relying on a man,” said Congresswoman Nita M. Lowey during her remarks.
Democratic Leader of the U.S. House of Representatives Nancy Pelosi, a longtime amfAR supporter, recalled that the reason she ran for Congress nearly 30 years ago was to improve the national response to AIDS, which was ravaging her native San Francisco. She has been a staunch supporter and leader in the fight against AIDS ever since. “The statistics regarding women and HIV are staggering, but HIV hits one person at a time, and we must address the needs of one person at a time,” said Leader Pelosi. “Every mother must have access to treatment and resources, and every woman must be protected by strong anti-violence laws and empowered by prevention.”
Dr. Rowena Johnston, amfAR vice president and director of research, reviewed progress on HIV cure research and described amAR’s efforts to develop the scientific basis for a cure. amfAR CEO Kevin Robert Frost ended the highly informative afternoon with an overview of the Foundation’s $100 million cure research investment strategy, whose centerpiece will be the establishment later this year of the first ever institute for HIV cure research. “There’s a great deal of enthusiasm for finding the cure right now. It will be complicated, it will be difficult, and it will be expensive, but at amfAR we’re all in,” said amfAR CEO Kevin Robert Frost.
The program and full roster of speakers is available here.
amfAR Issue Brief: Women and HIV/AIDS in the United States: Fast-Tracking the End of an Epidemic (March 2015)
amfAR Issue Brief: Women and HIV/AIDS Worldwide: Fast-Tracking the End of an Epidemic (March 2015)