Women face a significantly heightened risk of contracting HIV, a revelation unveiled by researchers affiliated with the Makerere University – John Hopkins University (MUJHU) Research Collaboration.
Dr. Phionah Kibalama Ssembambo underscored that this risk is further exacerbated among breastfeeding women, who are four times more susceptible to infection compared to their non-breastfeeding counterparts.
Addressing journalists at a meeting held at MUJHU, Dr. Kibalama highlighted that women in Uganda, on average, spend ten years of their lives either breastfeeding or pregnant.
This prolonged exposure to HIV underscores the urgency of addressing their vulnerability. Until recently, this demographic was excluded from participating in research aimed at introducing new prevention interventions, leaving them largely unprotected.
Dr. Sheila Bamweyana, another researcher, emphasized the challenges posed by excluding these women from research participation.
She cited a study testing the efficacy of the long-acting injection cabotegravir for HIV prevention. Despite initial requirements for women participants to use birth control or not be pregnant, numerous pregnancies occurred. Out of the 50 recorded pregnancies, 54% resulted in delivery or abortion, with no instances of congenital abnormalities—a compelling indication of the potential safety of involving such women in trials.
“We were recruiting women … risk of HIV,” Dr. Bamweyana stated, underscoring the importance of inclusive research practices.
Advocating for increased participation of pregnant women and breastfeeding mothers in clinical trials, the doctors draw on experiences like Dr. Brenda Gati’s work on the dapavirine Vaginal ring.
This ring, approved by the World Health Organization in 2021 as an HIV prevention method, underwent testing among exclusively breastfeeding mothers. Dr. Gati noted that, in comparison to oral drugs, the ring did not yield detectable drug levels in breast milk. However, some infants exhibited traces of dapivirine in their blood, originating from the vaginal ring.
“We also took precautions … infant blood levels,” Dr. Gati remarked, highlighting the meticulous nature of their research.
Despite the compelling evidence supporting women-centered HIV prevention interventions, their uptake, even among non-pregnant or non-breastfeeding women, remains low.
Notably, the dapivirine ring, researched in Uganda over a decade ago and approved by global regulators, has yet to be implemented for general use.