Source: statnews.com<\/p>\n
The arrival in 2012 of a daily pill to prevent HIV infection was widely hailed as a breakthrough that could drive new infections worldwide to very low levels. Eight years later, it is having a strong impact in some places and little or none in others.<\/p>\n
The real-world impact of pre-exposure prophylaxis, PrEP for short, certainly isn\u2019t living up to its high expectations among young women in sub-Saharan Africa, who account for more than one-quarter of the\u00a0800,000 new HIV infections\u00a0that occurred last year in the region.<\/p>\n
The complexities around taking a daily PrEP pill is one reason this therapy is having a limited impact there. A more fundamental problem is a delay in fully engaging African women, including African women scientists, in developing and testing new tools for fighting HIV.<\/p>\n
The U.S. Food and Drug Administration approved a\u00a0new version of PrEP\u00a0in October 2019 that, incredibly, was not tested in cisgender women at all, African or otherwise. As a result, it is available only for\u00a0men and transgender women. It\u2019s a sobering reality that, as we enter the second decade of the 21st century in a world that is supposedly \u201cwoke\u201d to the different manifestations of gender inequality, a new tool for preventing HIV infection has arrived with a \u201cmen only\u201d label. In Africa, it\u2019s an especially ominous sign.<\/p>\n
I am deeply concerned about the\u00a06,000 adolescent girls and young women\u00a0who become infected with HIV each week around the world. In some countries, girls and young women now account for\u00a080% of new adolescent infections. Overall, young women are twice as likely to acquire HIV as young men.<\/p>\n
To be fair, there have been efforts to conduct clinical trials with PrEP in African women. And the majority of participants in ongoing advanced-phase trials for HIV vaccines, antibodies, and injectable PrEP are women. But the poor results of PrEP trials in women to date should not have baffled some researchers. For example,\u00a0a PrEP trial\u00a0involving 5,000 women in South Africa, Uganda, and Zimbabwe found no reduction in infections. But that was mainly because many of the participants did not regularly take their pills.<\/p>\n
A recent study probing this\u00a0lack of adherence\u00a0pointed to social factors, including how taking a daily antiretroviral pill could\u00a0stigmatize women\u00a0as being at risk of HIV or even being HIV infected. Some women reported extreme reactions from family members and breakups with spouses or partners.<\/p>\n
The broader issue is a failure to understand the circumstances and preferences of African women and adolescent girls who urgently need protection against HIV. Beyond involving women as participants in clinical trials, fighting a disease that, in Africa, disproportionately affects women also requires involving more African women scientists \u2014 and African research institutions in general \u2014 in leading product development and testing.<\/p>\n
In my work to enable development and testing of new HIV vaccines and other preventive agents, I am constantly looking for ways to engage the communities we will be serving, especially young women, to understand what innovations they are most likely to embrace. One area of interest involves the possibility of using\u00a0manufactured HIV antibodies\u00a0to develop an injectable product that would provide protection for several months, which would help overcome the adherence challenges associated with PrEP.<\/p>\n
Working to ensure that HIV prevention tools are accessible and appropriate for African women and girls offers an approach that could be relevant beyond Africa. This work could, for example, offer valuable lessons for the United States, where\u00a0PrEP drugs\u00a0are not being widely used in\u00a0certain at-risk populations.<\/p>\n
We have arrived at a simultaneously hopeful and dangerous moment in the battle against the HIV\/AIDS pandemic. Hopeful because new tools are now available and in the research pipeline. Dangerous because, after years of steady declines in new infections, we have\u00a0hit a plateau, especially among young African women and girls.<\/p>\n
Overcoming these challenges demands a significant shift that delivers new investments in African-led and women-led HIV research endeavors across the continent. Research in South Africa has been well represented by women scientists, but that trend is not representative of the rest of southern Africa, East Africa, and West Africa. Recently, there has been a measure of new funding for women scientists that is helping them secure leadership roles in African research institutions and compete for grant support, but much more is needed.<\/p>\n
I bring to this work two decades of experience in clinical trial design and implementation. I also bring the experience of being a daughter who lost both of her parents to this terrible disease, and I am also the mother of a young African woman. I believe that these influences make me a better scientist.<\/p>\n
We can win the fight against HIV in Africa. But this virus is a resilient adversary. If we truly want to win, we must give African women opportunities to lead the battle.<\/p>\n","protected":false},"excerpt":{"rendered":"","protected":false},"author":1,"featured_media":4677,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[5],"tags":[3089,52,3090,647],"class_list":["post-4676","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-aids-hiv","tag-african-women","tag-hiv","tag-sound-asleep","tag-world"],"yoast_head":"\n