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Today is World AIDS Day, a time to pause and remember all who have died from HIV/AIDS and reflect on the devastation this disease has caused around the world. It also is a day to recommit ourselves to doing all we can to develop accessible and affordable drugs to treat HIV disease and associated infections, and to develop topical microbicides, vaccines and other tools to prevent HIV infection. World AIDS Day also gives us an opportunity to thank those who have worked so hard to stop HIV/AIDS: our prevention workers, treatment advocates, clinicians, researchers, religious leaders and, importantly, those who have volunteered for the clinical trials that are essential for developing new interventions against HIV/AIDS.
This years World AIDS Day theme could not be more appropriate: Women, Girls, HIV and AIDS. Women are disproportionately affected by the epidemic: they comprise more than half of the estimated 38 million people living with HIV/AIDS, including 57 percent of those living with HIV/AIDS in resource-limited Sub-Saharan Africa. Worldwide, the vast majority of women with HIV/AIDS became infected via heterosexual intercourse, frequently in settings where saying no to sex or insisting on condom use is not an option because of cultural factors, lack of financial independence and even the threat of violence.
In the United States, the proportion of all AIDS cases reported among adolescent and adult women has risen dramatically, from 6 percent in 1985 to 26 percent in 2002. Minority women, especially African Americans, are disproportionately represented in these alarming statistics. Of all AIDS cases reported in women in 2002 in the USA, fully two-thirds were among African Americans.
Of course, these numbers do not tell the full story: the scourge of HIV/AIDS in women cripples families, creates orphans, and impairs the economic and social foundation of communities and nations.
To stop the disturbing trend of an increasingly female HIV/AIDS pandemic, new ways of thinking are needed. Women must be empowered so that they are able to control their own lives and in particular their sexual relations. Toward that end, increased educational and employment opportunities for girls and women are essential, including gender-based AIDS education and societal campaigns that delineate the harmful effects of inequality in gender relations.
On the research front, National Institutes of Health (NIH)-supported researchers and their colleagues around the world are studying the mechanisms of HIV infection and the course of HIV/AIDS in women in order to devise new interventions. Promising research includes the development and testing of new candidates to be used as topical microbicides. It is hoped that when used prior to sexual intercourse, these agents would help protect women from HIV and other sexually transmitted infections. NIH supports a full spectrum of topical microbicide research, from basic research to clinical evaluation, with the goal of developing a potentially lifesaving tool. NIH funding for topical microbicide research rose from $47 million in fiscal year 2001 to an estimated $70 million in fiscal year 2005.
NIH is committed to working with our many collaborators pharmaceutical companies, universities, foreign governments and others across the world to develop safe, effective, and affordable drugs, microbicides, and vaccines. To accomplish these goals, however, we must test products in clinical trials, and to conduct such trials we must have volunteers, especially in those populations hardest hit by the pandemic. I encourage anyone concerned about the HIV/AIDS pandemic to learn more about ongoing research and to ask themselves how they can help end the AIDS crisis. For example, healthy HIV-negative individuals are needed as participants in HIV preventive vaccine trials in many cities across the United States; people can find out more by calling 1-800-HIV-0440 (outside of the United States, 1-301-519-0459) or visiting http://www.niaid.nih.gov.