Women's Health Inter-Network Scientific Committee

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In the US at the end of 2011, 24% of all people living with HIV were women (http://www.cdc.gov/hiv/group/gender/women/). Only 45% were engaged in care, and only 32% had achieved virologic suppression. The disease in the US occurs disproportionately among women of color. In 2010, Black women accounted for nearly two thirds (64%) of all estimated new HIV infections among women, while only accounting for 13% of the female population; white women accounted for 18% and Latinas 15% of new infections. Infection most commonly occurred through heterosexual sex (84%) and less frequently through intravenous drug use (16%). In 2010, HIV was the 7th leading cause of death for Black women ages 25-44, but did not rank among the top 10 leading causes of death for white women 25-44 (http://kff.org/hivaids/fact-sheet/women-and-hivaids-in-the-united-states/).

Approximately 17.4 million women were living with HIV infection in the world in 2014, and they represent 50% of the epidemic worldwide (http://www.who.int/hiv/data/). In sub-Saharan Africa in 2013, 59% of people living with HIV were women. Heterosexual sex is the dominant mode of HIV acquisition in women globally. For women aged 15-44 years, HIV/AIDS is the leading cause of death worldwide (http://www.who.int/mediacentre/factsheets/fs334/en/).

Summary of the WHISC Agenda

The primary mission of the WHISC is to develop optimal strategies for the prevention and treatment of HIV disease and related complications among women and to determine the pathogenesis of manifestations that are unique to women. The WHISC serves as liaison with other groups conducting research relevant to HIV-infected women and serves as an advisory committee in addressing issues such as reproductive decisions and contraception in clinical trials. There is broad representation on the WHISC from other pertinent committees and groups, which allows the WHISC to anticipate future research challenges through the rapid dissemination of new data from the various research groups.

The WHISC sees a woman's life as a continuum (childhood, adolescence, adulthood, pregnancy, and menopause) and care during her life should not be fragmented. The WHISC believes that HIV-infected women should have their health care needs managed comprehensively throughout the continuum of life. The WHISC therefore will work closely with other Networks/organizations to help achieve this goal.

General aims or goals of the WHISC are as follows:

  • To assess optimal therapy of HIV/AIDS in women and girls over the course of their lifetime;
  • To examine the impact of contraception, hormonal interventions, and pregnancy on the health of HIV-infected women;
  • To evaluate co-infections that specifically effect women (e.g., HPV disease including vulvar, anal, and cervical dysplasia and related cancers) and to evaluate opportunistic infections and treatment effects in women (e.g., TB in pregnant women);
  • To examine interactions between gender, body-mass index, pharmacokinetic parameters, and antiretroviral toxicity;
  • To work with the ACTG/IMPAACT Scientific and Resource Committees to optimize the design, conduct, and analysis of clinical trials in order to maximize the recruitment and retention of women into clinical trials;
  • To act as liaison between groups involved in either the care of or conduct of research with HIV-infected women. The WHISC will serve as the link between different HIV/AIDS related networks (ACTG, IMPAACT, HPTN, HVTN) and organizations (e.g., WIHS, HANC) that may impact the care of HIV infected women;
  • To act as an advisory committee regarding ACTG/IMPAACT clinical trial language and recommendations regarding reproductive, contraception, and pregnancy issues.
  • In the US arena, to encourage better representation of women in clinical studies in order to facilitate improved care for women in all stages of life. At present women represent a quarter of the US epidemic but only 15-19% of the participants in studies.
  • In the international arena, to focus on diseases or needs such as TB in pregnancy, contraception needs while taking TB and ARV medications, etc. Cervical cancer is the number one cause of death due to cancer in women in sub-Saharan Africa and HIV-infected women are at increased risk of developing cervical cancer. HIV-infected women face unique challenges; the WHISC aims to work in a research capacity to abate those challenges for women to improve their lives.