March 10, 2006
Statement of Anthony S. Fauci, M.D., Director, National Institute of Allergy and Infectious Diseases
National Institutes of Health
March 10, 2006 marks the first National Women and Girls HIV/AIDS Awareness Day. This day of recognition serves to raise awareness of the increasing impact of HIV/AIDS on women and girls in the United States and throughout the world. In the early days of the pandemic, relatively few women were infected with HIV. Today, however, women and girls represent one of the fastest growing groups affected by HIV/AIDS.
In 2004, 27 percent of all AIDS cases in the United States occurred in women, compared with only 7 percent in 1985, according to the U.S. Centers for Disease Control and Prevention. Women of color, especially African-American women, represent the vast majority of new cases among women. Among women newly diagnosed with HIV/AIDS between 2001 and 2004, an estimated 83 percent were African American or Hispanic. Younger women and girls are particularly vulnerable: females accounted for 38 percent of all individuals younger than 25 years diagnosed with HIV/AIDS from 2001-2004, compared with 27 percent of people aged 25 years and older.
Globally, the number of women and girls infected by HIV also continues to rise. In 2005, approximately 17.5 million women (46 percent of adults) were living with HIV/AIDS—one million more than in 2003, according to estimates of the Joint United Nations Programme on HIV/AIDS (UNAIDS). Worldwide, the vast majority of women and girls with HIV/AIDS became infected via heterosexual intercourse, frequently in settings where saying no to sex or insisting on condom use is not an option because of cultural factors, lack of financial independence and even the threat of violence.
Women experience HIV/AIDS differently from men. Biologically, they are more susceptible to acquiring HIV infection. Once infected, women suffer gender-specific manifestations of HIV, such as recurrent vaginal infections and their complications, as well as progression of disease at lower levels of virus. In addition, drug metabolism has been shown to differ in women versus men, potentially resulting in differential responses to antiretroviral therapy and an increased incidence of drug toxicities in women. Frequently, women infected with HIV have difficulty accessing health care, and they may carry the additional burden of caring for children and other family members who also are HIV-infected. They often lack social support and face other challenges that may interfere with their ability to adhere to treatment regimens. Research also shows that generally, HIV-infected women are diagnosed and enter health care services at later stages of infection than men.
To stop the disturbing trend of an increasingly female HIV/AIDS pandemic, we need new ways of thinking. Women must be empowered so that they can exert control over their own lives, particularly in their sexual relations. Toward that end, increased educational and employment opportunities for girls and women are essential, including gender-based AIDS education and societal campaigns that delineate the harmful effects of inequality in gender relations.
Woman-focused research is essential. In this regard, NIAID supports the Women's Interagency HIV Study (WIHS) aimed at better understanding the course of HIV/AIDS disease in women. In addition to WIHS, NIAID supports other clinical research networks to investigate gender-specific differences in HIV disease progression, complications and/or treatment, as well as tools of prevention. Since women are so severely affected by the pandemic, more women are needed to participate in clinical trials in order to address these gender-specific issues. Promising research includes the development and testing of new topical microbicides. When used prior to sexual intercourse, these woman-controlled agents may help protect women from HIV and other sexually transmitted infections. NIAID supports a full spectrum of microbicide research, from basic research to clinical evaluation, with the goal of developing potentially lifesaving tools. NIAID funding for topical microbicide research rose from $27 million in fiscal year 2001 to an estimated $52 million in fiscal year 2006.
National Women and Girls HIV/AIDS Awareness Day provides an opportunity to encourage women and girls to take personal responsibility for their own health and well-being, and reaffirms the commitment of the general public and the medical and public health communities to focus more attention on education, prevention, and treatment efforts among women and girls. Today, we renew our commitment to research aimed at measures that will empower women to protect themselves against this deadly disease.
Dr. Fauci is director of the National Institute of Allergy and Infectious Diseases at the National Institutes of Health in Bethesda, Maryland.
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Last Updated March 07, 2006