World AIDS Day 2012: Getting to zero

Why integrating HIV prevention and reproductive health care could help get us there

by Dr. Zeda Rosenberg, CEO, IPM

As World AIDS Day approaches tomorrow, we pause to reflect on the profound toll HIV/AIDS takes on millions of people, families and communities globally. We are also inspired by the progress being made against the epidemic and toward the goal of “getting to zero” — now a real possibility in the years to come.

World AIDS Day is also a time to remember that HIV places a disproportionate burden on women due to a combination of both biology and gender inequality. Right now, young women in sub-Saharan Africa — where the epidemic has hit hardest — are at least twice as likely to be infected with HIV than young men, and for many women, negotiating condom use is not realistic.

But vaginal microbicides containing antiretroviral (ARV) drugs may soon play a role in empowering women with a discreet way to prevent infection. One such product, tenofovir gel, has shown efficacy when used around the time of sex and is now in a confirmatory trial with results expected in 2014. IPM’s monthly ring, which slowly releases the ARV dapivirine over time to prevent HIV, is in Phase III clinical trials, with results expected in 2015.

Research has also accelerated on multipurpose prevention technologies (MPTs) that could address women’s varied health needs in one product that combines HIV prevention, contraception and even protection from sexually transmitted infections. These promising innovations recognize that women’s sexual and reproductive health needs do not exist in isolation. MPTs could potentially revolutionize a woman’s ability to significantly — and affordably — improve her health. For its part, with support from USAID, IPM is developing a 60-day ring to prevent HIV and unintended pregnancy, both significant causes of death for women worldwide.

However, for these technologies to truly transform women’s lives once they become available, efforts toward fully integrating health care systems need to continue. One of the most dramatic ways to affect the HIV epidemic is to unite HIV services and sexual and reproductive health care at every level.

Integrated care could increase access to health services for at-risk women, encourage healthy behaviors, reduce stigma around HIV, minimize the number of trips to the clinic, improve efficiency and save money. At the global level, it makes economic sense and would advance progress toward key global development goals — including markedly reducing the spread of HIV to women — by increasing collaboration across disciplines.

It is IPM’s mission to develop products women can use to prevent HIV and protect their health and to put them in the hands of those who need them most. Today, we add our voice to the call for integrated women’s health services to bring us all closer to delivering an HIV-free future for women everywhere.