The Promise of HIV Preventive Technologies

An HIV vaccine and microbicides both have huge potential to make a difference for reproductive health—especially for women of color, who are disproportionately affected by HIV/AIDS.

The quest for integration of HIV/AIDS and reproductive health persists among policy makers and advocates on a global scale. Women are increasingly being affected by HIV/AIDS, while also acquiring other STIs like HPV and cervical dysplasia. Although more HIV vaccines are being tested than ever before, thousands of HIV-negative volunteers are still needed to participate in clinical trials for preventive vaccines.

According to the National Institutes of Health Office of Vaccine Research, a vaccine "teaches" the immune system to recognize and defend against a virus (such as HIV), bacteria or other disease-causing agent. A preventive HIV vaccine could divert millions of deaths. Developing safe, effective and affordable vaccines that can prevent HIV infection in those who are uninfected is the best hope for controlling and ending the AIDS pandemic. And women are one sect of the population in dire need of prevention technologies due to the impact of HIV/AIDS on this vulnerable group.

The Centers for Disease Control and Prevention has found that women represent 27 percent of the estimated 40,000 new HIV/AIDS diagnoses in the United States. Of this, African American women account for 64 percent of new AIDS diagnoses and Hispanic women account for 15 percent. A more staggering conceptualization rests as one considers the harsh reality that African American women are about 24 times more likely to contract HIV than white women, and Hispanic women are 6 times more likely to contract the infection than their white counterparts. Globally, women account for about half of all HIV/AIDS infections worldwide. The overwhelming majority of these women contracted HIV through unprotected sex with infected men.

HIV interacts with women's reproductive health on many levels. The virus is transmitted more efficiently from men to women during sexual intercourse, and having another sexually transmitted infection (STI) may increase the risk of contracting HIV. Conversely, women with HIV are at increased risk for contracting other STIs. It is widely known that achieving good reproductive health remains a precursor for preventing HIV/AIDS. Integrating reproductive health and HIV/AIDS services makes sense and it is cost-effective. Ultimately, this integration may also lead to a reduction in stigma and increased access to care and treatment among resource-constrained populations.

A number of new HIV prevention technologies are in the late stages of clinical research. The trials particularly beneficial for women include those testing cervical barriers, HIV preventive vaccine trials and microbicide trials. Microbicides are topical creams or gels to be applied prior to sex in order to prevent HIV transmission and the transmission of other STIs. Clinical trials cannot thrive without the participation of volunteers. Throughout the trials' process, volunteers are counseled on how to reduce the behaviors that put them at increased risk for HIV transmission and other STIs. Volunteers are also fully informed of the process, the vaccines and other technologies being tested, and possible health outcomes. Volunteers who agree to participate in a trial conclude the preliminary consultative process by signing an informed consent document.

Diversity is desperately needed among these volunteers, and researchers have been actively recruiting women of color for both domestic trials as well as international trials. However, more must be done to increase awareness and education among this group. As researchers continue to seek out new and innovative prevention technologies for HIV/AIDS and other STIs, they must continually consider the inclusion of the communities most impacted by the disease. HIV/AIDS has proved itself to be an epidemic ravaging black and brown women across the globe. Because women of color may respond differently to both therapies and vaccines for these conditions, their participation in clinical trials is essential.