Presentation on theme: "Hadiyah Charles, Community HIV/AIDS Mobilization Project Naina Khanna, WORLD/U.S. Positive Women’s Network HIV Research Catalyst Forum April 21, 2010."— Presentation transcript:
Hadiyah Charles, Community HIV/AIDS Mobilization Project Naina Khanna, WORLD/U.S. Positive Women’s Network HIV Research Catalyst Forum April 21, 2010
Increase understanding of current landscape of Prevention Research for women Discuss emerging trends and key issues in prevention research Identify opportunities for advocacy and further collaboration to improve prevention research for women
Over 80% of women in U.S. are infected through heterosexual contact Globally, women are more than 50% of all infections For women, acquiring HIV is not primarily correlated with having a lot of sex partners or using injection drugs Factors that correlate with a woman’s risk for acquiring HIV include: poverty; violence; housing instability; food insecurity; and power dynamics in relationships
For women, “risky behavior” risk for HIV infection
Why do some women seem to have innate immunity to HIV and others don’t (including genetic markers - HLA)? How does homophobia impact the epidemic among women? What kinds of sex are serodiscordant heterosexual couples having; and has it changed since the release of the Swiss study data? What are the prevention needs of heterosexual men?
What motivates women or men to use a condom? Why is seroprevalence higher among WSW than among women who have sex with only men? What, if any, role does anal sex play in women’s risk for acquiring HIV? What percentage of women testing positive suspected they were at risk for acquiring HIV?
1. (D)EBIs - (Diffused) Effective Behavioral Interventions compendium of prevention interventions that showed “positive behavioral and/or health outcomes” Funded by CDC (Centers for Disease Control & Prevention) 17 DEBIs specifically target women 2. Homegrown Interventions: e.g. Healthy Love Workshop by SisterLove, Inc.
Focus is individual or group level Promote increased use of condom, fewer partners Limitations: Numbers reached are relatively small May not be reaching women at highest risk Asks women to change behaviors that may not be up to them: male condom; reduced number of partners Limited cultural relevance
PreP // pre-exposure prophylaxis (take it before you think you may be exposed) This strategy uses antiretrovirals to reduce the risk of HIV infection in HIV-negative people Currently in trials – nearly 20,000 people are enrolled How does this apply to women, especially in a U.S. context, who usually don’t perceive themselves as being at risk? What role does violence PreP play in women’s motivation to use a mechanism like PreP? Will women utilize PreP? What impact might MSMW taking PreP have on their female partners? What happens when PreP becomes PEP?
PEP // post-exposure prophylaxis (take it after you think you may have been exposed: rape; unplanned unprotected sex) Access, affordability, coverage, implications for health insurance, etc Limited options during pregnancy
Treatment as Prevention/TLC+ - Studies show if viral load is suppressed to undetectable the likelihood of transmission is low. - ARV treatment of people living with HIV may reduce their infectiousness and improve their outcomes Questions: - What are long term effects of starting treatment earlier? - Does this overemphasize burden of prevention on HIV-positive partner and minimize responsibility of negative partner? - Human rights implications
Currently in development Special considerations for women: Sex differences in effectiveness Pregnant women Women of reproductive potential Breastfeeding women Girls and adolescents Women are under-enrolled
Vaginal and Anal Microbicides (currently in development) Microbocide is a substance that would reduce risk of contracting HIV when applied vaginally or rectally Over a dozen trails are ongoing in ten countries Results are expected in mid 2010
FC1- female condom 1 was approved by the FDA for use in the US since 1993 FC2 - Female Condom 2 was approved by the FDA for use in the US in March 2009 FC2 offers women a choice, that they can initiate, to provide dual protection against unintended pregnancy and sexually transmitted infection including HIV. The Female Health Company www.femalehealth.comwww.femalehealth.com www.fc2femalecondom.comwww.fc2femalecondom.com
Intervene further “upstream” - on factors other than behavior and biology which influence risk Change balance of power Economic, policy, social, physical Examples: IMAGE project - South Africa 2 currently funded pilot CDC projects in Florida Housing (CHHC)
What about… Health care access (over 50% of HIV+ women not in care in U.S.) Violence prevention Economic opportunity for women Comprehensive Sex Education throughout lifetime?
How can we most effectively target testing resources for women? What structural interventions could work in the U.S. and how? How can structural interventions be integrated with biomedical and behavioral interventions? How do women want to use PreP? Are there ways (nutritional, other) to enhance innate immunity for women vulnerable to HIV infection in areas with generalized epidemics?
AIDS Vaccine Advocacy Coalition Global Campaign for Microbicides Prevention Justice Alliance www.preventionjustice.net National Women and AIDS Collective Chicago Female Condom Campaign – Put a ring on it www.ringonit.orgwww.ringonit.org Prevention Now! www.preventionnow.orgwww.preventionnow.org Happiness and Satisfaction - facebook (FC2)