NIH Symposium Launches OAR-ORWH Partnership to Advance Research on HIV and Women Across the Lifespan

On February 18, 2023, the Office of AIDS Research (OAR) and Office of Research on Women’s Health (ORWH) co-sponsored the NIH OAR-ORWH Women & HIV Symposium: Considerations from Across the Lifespan during the 13th International Workshop on HIV & Women 2023 in Seattle, Washington.

The symposium served as the public launch of a new joint program between OAR and ORWH that aims to achieve the NIH vision for women’s health, in which all women, including cisgender women, transgender women, and individuals assigned female at birth, receive evidence-based HIV care, prevention, and treatment tailored to their own needs, circumstances, and goals. The program also will support women in science careers to reach their full professional potential.

Despite tremendous advances in HIV and AIDS research over the last 40 years, women—particularly women of color, young women, and transgender women—remain disproportionately affected by the HIV pandemic. An intersectional, equity-informed, data-driven approach to research on HIV and women is the cornerstone of our new collaboration. We were thrilled to introduce this program through a symposium that highlighted innovative, multidisciplinary research to address the health of women with or affected by HIV. We invited six panelists who presented in pairs—an early career investigator and an established researcher—with each pair highlighting scientific opportunities across three topical areas.

Aging and Women’s Multimorbidity Burden
Lauren Collins, M.D., M.Sc., Emory University School of Medicine and the Grady Ponce de Leon Center
Catherine Godfrey, M.D., FRACP, President’s Emergency Plan for AIDS Relief (PEPFAR) at the U.S. Department of State, Office of the U.S. Global AIDS Coordinator and Global Health Diplomacy

Dr. Collins shared research findings indicating that women with HIV have an overall higher burden of non-AIDS-associated comorbidities, such as hypertension, diabetes, or cardiovascular disease, with onset at younger ages compared with women without HIV. ^1,2 Dr. Collins also reported higher rates of these comorbidities in women vs. men, but particularly among people with HIV.³ Expanding on this research, Dr. Godfrey noted the importance of further research to better understand the factors that lead to increased comorbidities in women with HIV and to discovery and development of optimal screening and treatment of comorbidities as the number of aging women with HIV increases.

Social and Structural Considerations for Women
Noelle St. Vil, Ph.D., M.S.W. LMSW, University at Buffalo School of Social Work
Jamila Stockman, Ph.D., M.P.H., University of California, San Diego, School of Medicine

Dr. St. Vil described her research that analyzed the impact of geographic access to substance use treatment and gender-based violence on likelihood of acquiring HIV. Among women at risk for HIV acquisition, the chance of experiencing violence decreased as geographic access to substance use treatment increased.⁴ Dr. Stockman noted that this research demonstrates the need for evidence-based interventions to address structural- and community-level factors contributing to risk for HIV acquisition, such as violence, criminalization of drug use or sex work, geography, and poverty. As with all prevention interventions, these programs must be tailored to the communities they serve.

Adolescent Girls and Young Women
Dvora Joseph Davey, M.P.H., Ph.D., University of California, Los Angeles, David Geffen School of Medicine and Fielding School of Public Health
Krista Dong, M.D., Ragon Institute of Mass General, MIT, and Harvard

Dr. Joseph Davey described an intervention in South Africa to increase pre-exposure prophylaxis (PrEP) initiation and adherence among pregnant and postpartum women, who experience increased likelihood of HIV acquisition due to biological and behavioral factors during pregnancy. In the intervention, 1,306 pregnant and lactating women received counseling on HIV prevention, including PrEP, at each prenatal visit through 12 months postpartum. After counseling, 86 percent of women initiated PrEP following their first prenatal visit, but adherence rapidly decreased by the three-month follow up visit.⁵ There were several barriers to daily PrEP use, such as forgetting to take the pill, side effects, and stigma. Dr. Dong underscored the need for researchers to engage with communities to better understand their needs and consider whether an intervention will work for the population and setting: “As investigators, we’re hardwired to look at biological endpoints; we’re not hardwired to think in a holistic manner about what the women want. Too often, we don’t ask what they want and need.”

The full Executive Summary of the symposium is available on the OAR website. The six panelists emphasized important considerations for women with and affected by HIV and discussed a range of research priorities to advance HIV prevention, treatment, and care related to women, aging, and multimorbidity. The symposium closed with two questions for panelists and participants to consider:

• What are the highest research priorities for women and HIV?
• What would be the most impactful way[s] for NIH to advance women-centered HIV research?

As we think about how to catalyze research on HIV and women, engagement with the community is critical. Input from our partners across the federal government, community groups, academia, and the private sector is essential to ensure the NIH HIV research program is responsive to emerging challenges. We want to hear your views on the opportunities in research related to HIV and women, as well as your perspectives of how NIH can advance women-centered HIV research across the lifespan. We invite our partners to share their perspectives with OAR and ORWH via email to womenandHIV@od.nih.gov.

The new collaboration between OAR and ORWH is crucial to enhance research at the intersection of HIV and women. NIH policies, resources for investigators, and targeted research funding continue to work together to help ensure that every woman or girl with or affected by HIV benefits from the best research. Essential to strengthening this research is promoting the recruitment, retention, reentry, and advancement of women in biomedical and research careers. As we observe Women’s History Month in March and National Women and Girls HIV/AIDS Awareness Day on March 10, it is important to recognize advancements in women’s health research and the women scientists who have contributed to these advancements. Read more about women who have contributed to health research on ORWH’s Women in Biomedical Careers website and watch the Pearls of Wisdom video profile series, also found on the website, which features perspectives and advice from groundbreaking women in science to inspire the next generation.

Together, we can advance efforts to prevent, treat, and cure HIV in all women across their lifespan.

Maureen M. Goodenow, Ph.D.
Associate Director for AIDS Research and
Director, Office of AIDS Research
National Institutes of Health

Janine Austin Clayton, M.D., FARVO
Associate Director for Research on Women’s Health and
Director, Office of Research on Women’s Health
National Institutes of Health

1 - Collins LF, Sheth AN, Mehta CC, et al. The Prevalence and Burden of Non-AIDS Comorbidities Among Women Living With or at Risk for Human Immunodeficiency Virus Infection in the United States. Clin Infect Dis. 2021;72(8):1301-1311. doi:10.1093/cid/ciaa204. pubmed.ncbi.nlm.nih.gov/32115628

2 - Collins LF, Sheth AN, Mehta CC, et al. Incident Non-AIDS Comorbidity Burden Among Women With or at Risk for Human Immunodeficiency Virus in the United States. Clin Infect Dis. 2021;73(7):e2059-e2069. doi:10.1093/cid/ciaa1928. pubmed.ncbi.nlm.nih.gov/33388773

3 - Collins LF, Palella F, Mehta CC, et al. Conference on Retroviruses and Opportunistic Infections. 6–10 March 2021. HIV Differentially Impacts Age-Related Comorbidity Burden Among U.S. Women and Men. Science Spotlight abstract 526.

4 - St. Vil, N. An Exploration of Geographic Access to Substance Abuse Treatment Programs, Violence Against Women, and HIV Risk Behaviors. Presented at: HPTN Annual Meeting 2022; June 5–8, 2022; Washington, DC. www.hptn.org/2022hptnannualmeetingpresentations

5 - Joseph Davey D, Nyemba DC, Castillo-Mancilla J, et al. Adherence challenges with daily oral pre-exposure prophylaxis during pregnancy and the postpartum period in South African women: a cohort study. J Int AIDS Soc. 2022;25(12):e26044. doi:10.1002/jia2.26044. pubmed.ncbi.nlm.nih.gov/36480171

Read the previous blog