are constantly looking for ways to cure HIV – the virus known to
cause AIDS – on the heels of reports that another person has been
cured of the disease. However, researchers must address the real
issue thwarting their attempts – the lack of women in clinical
trials for cures, treatments and vaccines.
are women than men living with HIV around the world. In fact, more
than half of the 35 million infections are found in women, and it’s
the number one cause of death in reproductive-aged women. New
infections in both Africa, South America and the southern U.S. are
found in women and are continuing the epidemic.
how men and women respond to HIV infection is different, and clinical
trials are primarily made up of gay men. Potential cure trials don’t
do very well.
AMFAR charity did an investigation in 2016, noting that women had 11
percent representation. Antiretroviral drug trials were a bit better,
with 19 percent of those involved being women.
38 percent, vaccine studies were considered the closest in
male/female equal participation.
Director of Research Rowena Johnson said if a cure is to be found, it
must work for everyone.
medical community realizes that the immune system of men and women
are different. For instance, the flu shot tends to elicit a more
powerful immune response in women than in men. And, the way HIV
infections respond to medication also different. For example, women’s
immune system tends to respond forcefully, keeping control of the
virus for up to seven years.
over time, this high alert can lead to women being diagnosed with
AIDS much sooner than men infected with the virus, which can lead to
more strokes and heart attacks.
of California, San Francisco Professor of Medicine Dr. Monica Gandhi
said there are all kinds of differences between the genders –
perhaps because of the hormonal effects. For instance, estrogen may
cause HIV to lie dormant, which makes it more difficult for drugs or
the immune system to kill.
differences could be seen even before children went through puberty.
One study found that 10 of the 11 children noted as being as elite
controllers – individuals who could suppress HIV to nearly
untraceable levels – were girls.
top of that, women don’t respond the same way as men to some drugs.
For instance, the drug Dolutegravir can cause neural tube defects in women who are using the drug. Nevirapine can cause severe rashes in women. And, despite all this evidence, men still make up most of the drug trial test subjects.
to these sex differences, it could hinder researchers in finding
potential cures – many of them tied to boosting the immune system
in killing HIV itself.
number of straight and gay men has always exceeded women, especially
in the beginning when the epidemic was seen more in gay men. Still,
three decades later, these are the same individuals trying to get
into clinical trials. Gay men have developed strong support networks
that have allowed them to learn of clinical trials that need
participants, which are often held in cities with high HIV rates.
HIV infected women are often isolated and don’t advocate for one
another. Women usually need help with transportation or childcare and
are often more comfortable with talking with female physicians –
very few trials will accommodate these needs.
of color in clinical trials is a real problem due to the wariness
they have from being exploited by researchers. And, scientists don’t
know how to regain the trust – to give these individuals the
information they need that won’t seem intrusive.
scientists are able to enroll women in their clinical trials, the
Food and Drug Administration imposes stricter guidelines due to their
stringent rules on women of childbearing years. For that reason, the
majority of researchers won’t enroll women, only getting
information after the drug has been released to the market.
has been a rise in the number of women for two recent long-acting
antiretroviral drugs – that can be injected each month instead of
being taken orally – 33 percent for one study and 23 percent in the
second study. Due to the treatment frequency, the trials are a bit
hit with the women with patients lining up outside the clinic to get
into the trial.
Despite the difficulty of getting women involved with trials, 75 percent of HIV infected individuals are men.