Women and HIV: Addressing Contemporary Issues
Main Article Content
In 2018, 18.8 million women were living with human immunodeficiency virus (HIV) and accounted for 52% of persons living with HIV worldwide. Despite exceptional gains made in reducing the HIV burden, women remain underrepresented and underserved. As we move toward ending the global HIV epidemic, key issues which impact women’s risk for acquiring HIV and the barriers which may prevent effective epidemic control in women will have to be addressed. The risks of women as receptive sex partners, the scarcity of HIV prevention options for women and pregnancy concerns require specific attention. Additionally, as the projected life-spans of women living with HIV increases, our focus must also expand to those issues specific to the aging woman. We must aim to reduce comorbidities and address unintended medication induced effects. To reach and sustain global control of HIV, psychological well-being and the quality of life of women living with HIV should be prioritized. This report investigates a few of the biological, psychological and scientific issues surrounding women which challenge the feasibility and sustainability of an end to the HIV epidemic.
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2. Centers for Disease Control and Prevention. Estimated per-act probability of acquiring HIV from an infected source, by exposure act. https://www.cdc.gov/hiv/risk/estimates/riskbehaviors.html. Accessed October 01, 2019.
3. Patel P, Borkowf CB, Brooks JT, Lasry A, Lansky A, Mermin J. Estimating per-act HIV transmission risk: a systematic review. AIDS. 2014;28(10):1509–1519. doi:10.1097/QAD.0000000000000298.
4. Bhatia S, Harrison A, Muriel K, et al. The role of relationship dynamics and gender inequalities as barriers to HIV-serostatus disclosure: qualitative study among women and men living with HIV in Durban, South Africa. Frontiers in Public Health. 2017. doi:10.3389/fpubh.2017.00188.
5. World Health Organization. Violence against women. https://www.who.int/news-room/fact-sheets/detail/violence-against-women. Published November 2017. Accessed November 14, 2019.
6. Ezechi OC, Gab-Okafor C, Onwujekwe D, Adu R, Amadi E, Herbertson E. Intimate partner violence and correlates in pregnant HIV positive Nigerians. Arch Gynecol Obstet. 2009;280:745-52. doi:10.1007/s00404-009-0956-9.
7. Jewkes R, Dunkle K, Nduna M, Shai, N. Intimate partner violence, relationship power inequity, and incidence of HIV infection in young women in South Africa: a cohort study. The Lancet. 2010;376 (9734):41-48. http://www.sciencedirect.com/science/article/pii/S014067361060548X. Accessed October 30, 2019.
8. Wall, L. The many facets of shame in intimate partner sexual violence. Melbourne:Australian Centre for the Study of Sexual Assault: Australian Institute of Family Studies. 2012. 10/ACSSA Research Summary/1. http://aifs.gov.au/publications/many-facets-shame-intimate-partner-sexual-violence/introduction. Published January 2012. Accessed November 1, 2019.
9. Holden S. Failing women, withholding protection: 15 lost years in making the female condom accessible. Oxfam Policy and Practice. http://policy-practice.oxfam.org.uk/publications. Published 06 Aug 2009. Accessed October 25 2019.
10. Drew LW, Blair M, Miner RC, Conant M. Evaluation of the virus permeability of a new condom for women.Sex Transm Dis. 1990;17(2):110–112. https://www.ncbi.nlm.nih.gov/pubmed/2163113. Accessed November 14, 2019.
11. Evans ME, Tao G, Porter SE, Gray SC, Huang YA, Hoover KW. Low HIV testing rates among US women who report anal sex and other HIV sexual risk behaviors, 2011–2015. Am J Obstet Gynecol. 2018;219:383.e1-7. https://www.ncbi.nlm.nih.gov/pubmed/30144401. Accessed October 01, 2019.
12. Baeten JM, Ludo L, Overbaugh J. The influence of hormonal contraceptive use on HIV-1 transmission and disease progression. Clinical Infectious Diseases. 2007;45(3):360-369. https://doi.org/10.1086/519432. Accessed November 14, 2019.
13. May M, Gompels M, Delpech V, et al. Impact of late diagnosis and treatment on life expectancy in people with HIV-1: UK collaborative HIV cohort (UK CHIC) study. BMJ. 2011;343:d6016. doi:10.1136/bmj.d6016.
14. Morrison CS, Chen PL, Kwok C, et al. Hormonal contraception and the risk of HIV acquisition: an individual participant data meta-analysis. Plos Med. 2015;12(1):e1001778. doi: 10.1371/journal.pmed.1001778.
15. Brind J, Condly SJ, Mosher SW, Morse AR, Kimball J. Risk of HIV Infection in Depot-Medroxyprogesterone Acetate (DMPA) Users: A Systematic Review and Meta-analysis. Issues Law Med. 2015; 30 (2):129-139. https://www.ncbi.nlm.nih.gov/pubmed/26710371. Accessed October 08, 2019.
16. Centers for Disease Control and Prevention. Updated guidelines for antiretroviral postexposure prophylaxis after sexual, injection drug use, or other nonoccupational exposure to HIV-United States, 2016. Atlanta, GA: Centers for Disease Control and Prevention,US Department of Health and Human Services. https://stacks.cdc.gov/view/cdc/38856. Published April, 2016. Updated May 23, 2018. Accessed October 30, 2019.
17. World Health Organization. Post exposure prophylaxis. https://www.who.int/hiv/topics/prophylaxis/en. Accessed November 2019.
18. Spinner CD, Boesecke C, Zink A, et al. HIV pre‑exposure prophylaxis (PrEP): a review of current knowledge of oral systemic HIV PrEP in humans. Infection. 2016;44(2):151-158. doi:10.1007/s15010-015-0850-2.
19. Cohen MS, Chen YQ, McCauley M, et al. Antiretroviral Therapy for the Prevention of HIV-1 Transmission. N Eng J Med. 2016;375:830-839. doi: 10.1056/NEJMoa1600693.
20. Mera-Giler R, Das M, Hawkins T, Asubonteng J, Magnuson D, McCallister S. PrEP significantly reduces the rate of new HIV diagnoses in the US metropolitan statistical areas independent of treatment as prevention (2012-2017). Poster presented at: ID Week; October 5, 2019; Washington DC.
21. Raifman J, Schwartz S, Sosnowy C, et al. Pre-exposure prophylaxis awareness and use among cisgender women at a sexually transmitted disease clinic. J Acquir Immune Defic Syndr. 2019;80(1):36-39. doi:10.1097/QAI.0000000000001879.
22. Anderson PL, Kiser JJ, Gardner EM, Rower JE, Meditz A, Grant RM. Pharmacological considerations for tenofovir and emtricitabine to prevent HIV infection. J Antimicrob Chemother. 2011;66(2):240-250. doi:10.1093/jac/dkq447.
23. Centers for Disease Control and Prevention. Preexposure prophylaxis for the prevention of HIV infection in the United States - 2017 update a clinical practice guideline. Atlanta, GA: Centers for Disease Control and Prevention, US Dept of Health and Human Services; 2018.
24. Hendrix CW. The clinical pharmacology of antiretrovirals for HIV prevention. Curr Opin HIV AIDS. 2012;7(6):498–504. doi:10.1097/COH.0b013e32835847ae.
25. Flash CA, Dale SK, Krakower DS. Pre-exposure prophylaxis for HIV prevention in women: current perspectives. Int J Womens Health. 2017;9:391-401. doi: 10.2147/IJWH.S113675.
26. Descovy [package insert]. Foster City, CA: Gilead Sciences; 2019.
27. Hare CB, Coll J, Ruane P, et al.. The phase 3 DISCOVER study: daily F/TAF or F/TDF for HIV preexposure prophylaxis. Poster presented at: Conference on Retroviruses and Opportunistic Infections; March 4-7, 2019; Seattle, Washington.
28. Brooks JT, Buchacz K, Gebo KA, Mermin J. HIV infection and older Americans: the public health perspective. Am J Public Health. 2012;102:1516–26.
29. WHO Technical brief: Preventing HIV during pregnancy and breastfeeding in the context of pre-exposure prophylaxis (PrEP). Geneva, Switzerland: World Health Organization; 2017. https://apps.who.int/iris/bitstream/handle/10665/255866/WHO-HIV-2017.09-eng.pdf. Published July 2017. Accessed November 14, 2019.
30. Recommendations for the Use of Antiretroviral Drugs in Pregnant Women with HIV Infection and Interventions to Reduce Perinatal HIV Transmission in the United States: Table 7. Situation-Specific Recommendations for Use of Antiretroviral Drugs in Pregnant Women and Nonpregnant Women Who Are Trying to Conceive. United States: U.S. Department of Health and Human Services ; 2019. https://aidsinfo.nih.gov/guidelines/html/3/perinatal/522/table-7--situation-specific-recommendations-for-use-of-arvs. Updated December 7, 2018. Accessed November 12, 2019.
31. Recommendations for the Use of Antiretroviral Drugs in Pregnant Women with HIV Infection and Interventions to Reduce Perinatal HIV Transmission in the United States: General principles regarding use of antiretroviral drugs during pregnancy: Teratogenicity. United States: U.S. Department of Health and Human Services; 2018. https://aidsinfo.nih.gov/guidelines/html/3/perinatal/170/teratogenicity. Updated December 7, 2018. Accessed November 14, 2019.
32. Zash R, Holmes L, Diseko M, et al. Neural-Tube defects and antiretroviral treatment regimens in Botswana. N Engl J Med. 2019; 381(9): 827-840. doi:10.1056/nejmoa1905230.
33. Raesima M, Ogbuabo C, Thomas V, et al. Dolutegravir use at conception — Additional surveillance data from Botswana. N Engl J Med. 2019; 381:885-887. doi: 10.1056/NEJMc1908155.
34. Update of recommendations on first- and second-line antiretroviral regimens. Geneva, Switzerland: World Health Organization; 2019. https://apps.who.int/iris/bitstream/handle/10665/325892/WHO-CDS-HIV-19.15-eng.pdf?ua=1. Published July 2019. Accessed November 12, 2019.
35. Recommendations for the Use of Antiretroviral Drugs in Pregnant Women with HIV Infection and Interventions to Reduce Perinatal HIV Transmission in the United States: Recommendations for Use of Antiretroviral Drugs During Pregnancy: Overview. United States: U.S. Department of Health and Human Services; 2018. https://aidsinfo.nih.gov/guidelines/html/3/perinatal/488/overview. Updated December 7, 2018. Accessed November 12, 2019.
36. Recommendations for the Use of Antiretroviral Drugs in Pregnant Women with HIV Infection and Interventions to Reduce Perinatal HIV Transmission in the United States: Recommendations for Use of Antiretroviral Drugs During Pregnancy: Table 6. What to Start: Initial Combination Regimens for Antiretroviral-Naive Pregnant Women. United States: U.S. Department of Health and Human Services; 2018. https://aidsinfo.nih.gov/guidelines/html/3/perinatal/487/table-6---what-to-start--initial-combination-regimens-for-antiretroviral-naive-pregnant-women. Updated December 7, 2018. Accessed November 12, 2019.
37. HIV/AIDS. Geneva, Switzerland: World Health Organization; 2019. https://www.who.int/news-room/fact-sheets/detail/hiv-aids. Published November 15, 2019. Accessed November 15, 2019.
38. Recommendations for the Use of Antiretroviral Drugs in Pregnant Women with HIV Infection and Interventions to Reduce Perinatal HIV Transmission in the United States: Maternal HIV Testing and Identification of Perinatal HIV Exposure. United States: U.S. Department of Health and Human Services; 2019. https://aidsinfo.nih.gov/guidelines/html/3/perinatal/508/maternal-hiv-testing-and-identification-of-perinatal-hiv-exposure. Updated April 16, 2019. Accessed November 12, 2019.
39. Recommendations for the Use of Antiretroviral Drugs in Pregnant Women with HIV Infection and Interventions to Reduce Perinatal HIV Transmission in the United States: Guidance for Counseling and Managing Women Living with HIV in the United States Who Desire to Breastfeed. United States: U.S. Department of Health and Human Services; 2019. https://aidsinfo.nih.gov/guidelines/html/3/perinatal/513/counseling-and-management-of-women-living-with-hiv-who-breastfeed. Updated March 27, 2018. Accessed November 12, 2019.
40. Updates on HIV and Infant Feeding. Geneva, Switzerland: World Health Organization; 2016. https://apps.who.int/iris/bitstream/handle/10665/246260/9789241549707-eng.pdf;jsessionid=068FDE296A52FC88AC1BF283431300C2?sequence=1. Published 2016. Accessed November 14, 2019.
41. MacCarthy S, Rasanathan JJ, Nunn A, Dourado I. "I did not feel like a mother": the success and remaining challenges to exclusive formula feeding among HIV-positive women in Brazil. AIDS Care. 2013;25(6):726–731. doi:10.1080/09540121.2013.793274.
42. Bastos, R, Bellini N, Vieira, C, et al. Psychological phases of pregnant women with HIV: a qualitative study in a hospital. Rev Iberoam Bioet. 2019;27(2):doi:10.1590/1983-80422019272311.
43. Kapetanovic S, Dass-Brailsford P, Nora D, Talisman, N. Mental health of HIV-seropositive women during pregnancy and postpartum period: a comprehensive literature review. AIDS Behav. 2014;18(6):1152–1173. doi:10.1007/s10461-014-0728-9.
44. Parkhurst J. Understanding the correlations between wealth, poverty, and human immunodeficiency virus infection in African countries. Bulletin of the World Health Organization. 2010;88:519-526. doi: 10.2471/BLT.09.070185.
45. Center for Disease Control. CDC HIV/AIDS Facts: HIV among persons aged 50 and older. Feb 2008. http://www.cdc.gov/hiv/pdf/library_factsheet_HIV_among_PersonsAged50andOlder.pdf, Accessed August 5, 2016. CDC fact sheet on HIV among older adults including numbers for HIV/AIDS diagnoses, living with HIV and deaths, prevention challenges and CDC role. Accessed October 25, 2019.
46. National HIV/AIDS and Aging Awareness Day Sept. 18. American Psychological Association. https://www.apa.org/pi/aids/resources/aging-awareness. Accessed November 13, 2019
47. Imai K, Sutton MY, Mdodo R, Del Rio C. HIV and menopause: A systematic review of the effects of HIV infection on age at menopause and the effects of menopause on response to antiretroviral therapy. Obstet Gynecol Int. 2013(2013);340309. doi:10.1155/2013/340309.
48. Stoff DM, Colosi D, Rubtsova A, Wingood G. HIV and aging research in women: An overview. Curr HIV/AIDS Rep (2016) 13:383–391 DOI 10.1007/s11904-016-0338-4.
49. Zhao M, Vaartjes I, Graham I, et al. Sex differences in risk factor management of coronary heart disease across three regions. Heart. 2017;103:1587-1594. https://heart.bmj.com/content/103/20/1587.info. Accessed November 09, 2019.
50. Sharma, S. & Wood, M.J. Curr Treat Options Cardio Med. (2018); 20(10):81. doi: 10.1007/s11936-018-0676-1.
51. Poe J, Ladak A. Unusual weight gain after regimen switch: a case report. Poster presented at: American Conference for the Treatment of HIV; April 11-13, 2019; Miami, Fl.
52. Logsdon RG, McCurry SM, Teri L. Evidence-based interventions to improve quality of life for individuals with dementia. Alzheimers Care Today. 2007;8(4):307-318. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2585781/. Accessed November 14, 2019.
53. Milanga M, Rutter L. Policy Briefing: Dolutegravir in Southern & Eastern Africa and the right to choose. Global Access Project. https://healthgap.org/wp-content/uploads/2018/11/Policy-Brief-Dolutegravir-in-Southern-Eastern-Africa.pdf. Published November 2018. Accessed November 14, 2019.
54. Beach MC, Duggan P, Moore R. Is Patients’ Preferred involvement in health decisions related to outcomes for patients with HIV? J Gen Intern Med. 2007; 22(8): 1119-1124. https://link.springer.com/article/10.1007/s11606-007-0241-1. Accessed November 14, 2019.
55. Ford N, Calmy A, Mofenson L. Safety of efavirenz in the first trimester of pregnancy: an updated systematic review and meta-analysis. AIDS. 2011; 25(18): 2301-2304. doi: 10.1097/QAD.0b013e32834cdb71
56. Shapiro RL, Hughes MD, Ogwu A, et al. Antiretroviral regimens in pregnancy and breast-feeding in Botswana. N Engl J Med. 2010; 362:2282-2294. Doi: 10.1056/NEJMoa0907736
57. Gaolathe T, Wirth KE, Holme MP, et al. Botswana’s progress towards achieving the 2020 UNAIDS 90-90-90 antiretroviral therapy and virological suppression goals: a population-based survey. The Lancet HIV. 2016;3(5):e221-e230.