Sydney - Nearly half of all people living with HIV/AIDS globally are women, but there is alarmingly very little research into their unique medical needs, activists and health experts said Monday at an international AIDS conference. "There are approximately 40 million people living with HIV worldwide, and 17.7 million are women, but research, policy and prevention efforts are still behind in adjusting the focus to meet their needs," said Francoise Barre-Sinoussi, a director in the virology department of the Institut Pasteur in Paris, where HIV, the human immunodeficiency virus that causes AIDS (acquired immune deficiency syndrome), was discovered.
Today, a staggering 76 per cent of all HIV-positive women live in sub-Saharan Africa. An estimated 30 per cent of adults living with HIV in Asia, and 51 per cent in the Caribbean, are women. AIDS is the leading cause of death for African-American women aged 25-34 years in the US, according to various UN agencies.
Women at the 4th International AIDS Society (IAS) Conference on Pathogenesis, Treatment and Prevention on Monday demanded a comprehensive research plan on HIV/AIDS that specifically addresses women's health.
The biennial conference features the latest developments in biomedical prevention, treatment and clinical practise and explores how scientific advances can practically inform the global response to AIDS.
The science is clear. HIV transmission from men to women is more efficient than from women to men, as women have a larger mucosal surface where micro-lesions can occur and the virus can easily enter the bloodstream.
Women are also more susceptible to sexually transmitted infections (STIs) than men, which enhances the possibility of HIV infection. Most STIs usually go undetected and untreated in women, scientists said.
When having unprotected heterosexual sex, women are eight times more likely to become infected with HIV than men, according to Barre-Sinoussi.
There are negligible studies on the impact of various anti-AIDS drugs in women's bodies. "There is no such thing as a 'one size fits all' medication," said Sharon Walmsley, professor of medicine at the University of Toronto.
"HIV medications can affect women differently than men," she said. The reactions to treatment are due to differences in body size, fat content, hormonal effects. Walmsley said HIV-positive women of child-bearing age needed to have medication appropriate for pregnancy, as more than half of all pregnancies are unplanned.
"When I was first diagnosed I was told that HIV was a death sentence and I would not live past Christmas," said Sarah W, an HIV-positive woman. "That was 22 years ago. Since then I have given birth to two healthy children."
"With the right treatment it is possible to safely carry a child as a positive woman on antiretroviral therapy, but it requires an honest and open discussion between women and their physicians," Sarah said. According to the U.S. Centres for Disease Control and Prevention, many women learn of their HIV status only once they are pregnant.
There are other issues at stake. Some studies have shown that HIV-positive women are at a greater risk of depression than men. Depression is often a consequence of poor adherence to the toxic treatment regime, which then leads to a rapid decline in health.
Jacqueline Gahagan, professor for health promotion at Dalhousie University in Halifax, Canada, called AIDS "a global women's health crisis that deserves a global women's health response."
Yet women's rights and health issues have, for decades, been at the bottom of the ladder of scientific and social science research. It was only in 2004, that statistics for women were disaggregated for the first time by UNAIDS. Even today, there are no global statistics for the number of women under treatment.
AIDS was first recognised as a disease of young, gay men in the US in 1981. As there has been no attempt to chronicle the disease among women, what is lesser known is that two months after the first cases were reported in men, doctors identified the same syndrome in a woman.
A highlight of the IAS conference is the Sydney Declaration, which urges governments, multi-lateral agencies and donors to allocate 10 per cent of all resources for HIV programming, toward more research. Without this funding it will be impossible to maintain a sustained response to the AIDS pandemic, experts said. There has been no indication of ear-marking part of these funds for research exclusive to women.
Some activists merely asked for the bare minimum. "Many women in Kenya and other countries in Africa do not have the necessary food and water to take the trial medications as prescribed," said Josephine Okumu, an HIV-positive Kenyan.
