Statement of Anthony S. Fauci, M.D.
Director, National Institute of Allergy and Infectious Diseases
National Institutes of Health on National Women and Girls HIV/AIDS Awareness Day
March 10, 2009
The fourth annual National Women and Girls HIV/AIDS Awareness Day reminds us
of the special risks that HIV/AIDS poses for women and girls. In
response to the unique issues they face, we renew our resolve to
help women and girls protect themselves from the virus and the
Women and girls represent more than a quarter of all new HIV infections in the
United States. More than 278,000 women and adolescent girls in
this country are living with HIV;nearly 94,000 American women
and girls with AIDS have died since the epidemic began. Globally,
half of the estimated 33 million people living with HIV are female,
but in sub-Saharan Africa, women make up almost 60 percent of the
Here in the United States, minority women and girls bear a disproportionately
heavy burden of HIV/AIDS, accounting for 80 percent of U.S. females
living with the virus. African-American women acquire HIV at nearly
15 times the rate of white women.Consequently, although African-American
women represent 13 percent of the female U.S. population, they
account for 65 percent of all American women infected with HIV
and 62 percent of all U.S. female AIDS cases. Hispanic women in
this country also suffer disproportionately from HIV/AIDS, becoming
infected with HIV at nearly four times the rate of white women.
It is critical that women and adolescent girls learn the HIV status of their
male sexual partners and regularly monitor their own infection
status. This is essential because 80 percent of new HIV infections
in American women and girls result from sex with an infected male
partner, and one-fifth of all Americans living with HIV infection
do not know they are infected. Early diagnosis of HIV allows for
counseling and prompt treatment. Potent HIV therapies prolong life
and reduce the risk of further HIV transmission by dramatically
lowering the amount of virus in the blood and other bodily fluids.
Knowing one’s HIV status also creates opportunities for women to
make informed choices about childbearing and to adjust their behavior
to avoid infecting others. The National Institute of Allergy and
Infectious Diseases (NIAID), part of the National Institutes of
Health, strongly endorses testing for HIV during the routine medical
care of adults, adolescents and pregnant women, as the Centers
for Disease Control and Prevention and the American College of
Women and girls often acquire HIV in situations where it is difficult or impossible
for them to refuse sex or negotiate condom use. For this reason,
NIAID places a priority on developing HIV prevention tools that
women can implement independently. One such method under study
is a microbicide—a gel, cream or foam intended to prevent
the sexual transmission of HIV when applied topically inside the vagina or
rectum. A recently completed NIAID clinical trial of a microbicide
called PRO 2000 (http://www3.niaid.nih.gov/news/newsreleases/2009/HPTN_035_gel.htm)
found the experimental product to be 30 percent effective. Although
this result fell just short of statistical significance, it was
the first indication that a microbicide might work in people. More
definitive results will come from a larger clinical trial of PRO
2000 being conducted by the Medical Research Council and the Department
for International Development of the United Kingdom and scheduled
to conclude later this year. Meanwhile, NIAID will begin clinical
tests of a different microbicide, one that contains the antiretroviral
drug tenofovir. Many other NIAID studies of microbicides at earlier
stages of development also are under way.
Another mode of HIV prevention, one that women and girls at high risk for HIV
could implement independently, would involve taking antiretroviral
drug regimens to protect themselves from infection. NIAID-sponsored
studies are testing this experimental approach, known as pre-exposure
prophylaxis (PrEP), with the first clinical results expected this
In addition to studies of such HIV prevention tools, NIAID supports research
on HIV/AIDS treatment, complications and disease progression among
women and girls. For example, several NIAID-sponsored clinical
trials aim to optimize HIV/AIDS therapy for women who previously
took certain antiretroviral drug regimens to prevent passing the
virus on to their children during pregnancy or birth.
National Women and Girls HIV/AIDS Awareness Day reminds us of the female face
of HIV/AIDS and its challenges. NIAID is committed to developing
HIV prevention tools that empower women and girls to protect themselves.
I encourage women and adolescent girls to embrace routine HIV testing,
to learn the HIV status of their sexual partners when possible,
and to employ "safe sex" practices (http://www.nlm.nih.gov/medlineplus/ency/article/001949.htm).
The abhorrent racial disparity among new HIV/AIDS cases in the
United States and the gender disparity of HIV/AIDS in sub-Saharan
Africa demand our attention as national and global communities.
By recognizing and responding to the unique risks that HIV/AIDS
poses for women, we will go far toward curbing the epidemic.
Each year, the NIH Office of AIDS Research (http://www.oar.nih.gov/) produces
a Trans-NIH Plan for HIV-Related Research that identifies strategic
priorities for all areas of HIV/AIDS research. The plan is developed
in collaboration with experts from the NIH institutes and centers,
other government agencies, non-governmental organizations and HIV/AIDS
community representatives. The Fiscal Year 2010 Trans-NIH Plan
for HIV-Related Research (http://www.oar.nih.gov/strategicplan/fy2010/index.asp)
contains a section on microbicides and a chapter specifically devoted
to research addressing HIV/AIDS in special populations, including
women and girls.
Dr. Fauci is director of the National Institute of Allergy and Infectious Diseases
at the National Institutes of Health in Bethesda, Maryland.
Media inquiries can be directed to the NIAID Office of Communications at 301-402-1663,
NIAID conducts and supports research—at NIH, throughout the United States, and
worldwide—to study the causes of infectious and immune-mediated diseases,
and to develop better means of preventing, diagnosing and treating these illnesses.
News releases, fact sheets and other NIAID-related materials are available on
the NIAID Web site at http://www.niaid.nih.gov.
The National Institutes of Health (NIH) — The Nation's
Medical Research Agency — includes 27 Institutes and
Centers and is a component of the U.S. Department of Health and
Human Services. It is the primary federal agency for conducting
and supporting basic, clinical and translational medical research,
and it investigates the causes, treatments, and cures for both
common and rare diseases. For more information about NIH and
its programs, visit www.nih.gov.
1. Centers for Disease Control and Prevention (CDC). 2008.
HIV prevalence estimates—United States, 2006. MMWR 57(39):1074.
2. CDC. 2009. HIV/AIDS Surveillance Report, 2007. Vol. 19. Atlanta: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, p. 19.
3. UNAIDS. 2009. Executive summary. 2008 Report on
the global AIDS epidemic. Geneva: UNAIDS, pp. 5, 8.
4. CDC. 2009, p. 22.
5. CDC. 2008. Subpopulation estimates from the HIV incidence surveillance system—United States, 2006. MMWR 57(36):985.
6. CDC. 2009, pp. 22, 26.
7. CDC. 2008, Subpopulation estimates, p. 985.
8. Ibid., p. 985.
9. CDC. 2008. HIV prevalence estimates, p.1075.