Urgent needs of HIV-positive women discussed

Women Living Positive, a roundtable discussion at the IAS congress in Sydney, featured the perspectives of an international panel, including experts in HIV research and medicine, an HIV-positive woman and a member of Australia's National Association of People Living with HIV/AIDS (NAPWA), on the progress that has been made, and what remains to be done to address the needs of HIV-positive women.

Francoise Barre-Sinoussi, Ph.D., director, Regulation of Retroviral Infections Unit, Virology Department, Institut Pasteur, Paris, France, where the HIV virus was discovered, revealed the increasing complexity of HIV infection trends in women worldwide:

• There are approximately 40 million people living with HIV worldwide and 17.7 million of these are women, but research, policy and prevention efforts are still behind in adjusting the focus to meet their needs.
• Biologically, women are more likely to get infected with HIV. When having unprotected heterosexual sex, women are as many as eight times more likely to become infected with HIV than men.
• Women are often the primary caregivers in a family and therefore may have different pressures and responsibilities than men. In some countries, HIV has significantly increased the burden of care for many women. Poverty and poor public services have also combined with HIV to turn the care burden for women into a crisis with far-reaching social, health and economic consequences.

Sharon Walmsley, M.Sc., M.D., professor of medicine, University of Toronto, senior scientist, Toronto Hospital Research Institute, and director, Clinical Research, Immunodeficiency Clinic, Toronto Hospital, Canada, emphasized the unique treatment needs of HIV-positive women:

• HIV medications can affect women differently than men. Women exhibit different characteristics from men for many of the complications of antiretroviral therapy.
• Because more than half of all pregnancies are unplanned, it is vital that HIV-positive women and their physicians incorporate family planning into their discussions when initiating therapy and evaluate options that will be appropriate if they become pregnant because some medications, such as Viramune(R) (nevirapine), are preferred for use for women of childbearing age.
• There is no such thing as a "one size fits all" medication. It is important to assess family history and the presence of other illnesses such as diabetes, liver, kidney or heart disease, and depression, as these can help guide the selection of a treatment regimen that will work best for the individual.

Sarah W., an HIV-positive woman, shared her personal story of living with the disease, as well as the keys to success that have helped her remain healthy:

• When I was first diagnosed I was told that HIV was a death sentence and I would not live past Christmas. That was 22 years ago. Since then I have had two healthy children.
• It is essential for women to become actively involved in their care, and to make sure that their physician treats them as a partner when making decisions affecting their health
• 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.

Katherine Leane, co-chair, Positive Women's Network, NAPWA Australia, discussed the need for more resources and support groups catering to the needs of HIV-positive women:

• AIDS Service Organizations are a crucial source of support for positive women. More so than men, HIV-positive women in Australia often find themselves simultaneously managing illness, work and parenting responsibilities, and need support systems to help them cope.
• Physicians, support groups and government can ensure that women at risk choose to come forward for testing, secure in the knowledge that they can get the support and care they need by providing better information, better support and counseling, and by supporting women's rights.