WOMEN’S MONTH 2021: A LOOK AT WOMEN IN HIV

Women, specifically young women, are the face of the HIV epidemic in sub-Saharan Africa. While women are more likely to test for HIV, more likely to initiate and adhere to treatment, and more likely to have improved HIV outcomes than their male counterparts, they remain disproportionality vulnerable to infection –  adolescent girls and young women in sub-Saharan Africa are eight times more likely than their male peers to be HIV-positive – due to a multitude of biological, physiological, and socioeconomic factors.

Even though women bear the burden of the HIV epidemic, they are more likely to be caretakers for most people living with HIV, to lead community activism and advocacy for better HIV care and health service access, and to advance basic and clinical HIV science – with female scientists and academics dominating the field of HIV research.

As Women’s Month comes to an end, we would like to highlight some of the key women who have made a historically significant impact on the fight against HIV/AIDS. This is not an exhaustive list – it is only a small selection of some of these incredible heroines that have moved us collectively forward in the battle against HIV.

“We have to show them what women can do in science!” – FRANCOISE BARRE-SINOUSSI

Without the contributions of the first woman on our list, much of the battle against HIV/AIDS would not have been possible. Francoise Barre-Sinoussi was the scientist whose discovery of HIV led to blood tests capable of detecting the infection, and ultimately to anti-retroviral medicines that have made HIV/AIDS a manageable chronic disease. In 2008, Barre-Sinoussi, along with her mentor Luc Montagnier, was awarded the Nobel Prize in Physiology or Medicine for the discovery.

Before her retirement in 2017, Barre-Sinoussi spent her career tirelessly advocating for the people around the world who remained without access to ARV’s. After earning her PhD in 1974, she worked at the Pasteur Institute to study the link between retroviruses and cancers. It was there that a virologist requested help identifying the cause of an alarming new epidemic that seemed to be affecting homosexual men. Within just 2 weeks, Barre-Sinoussi and her team had discovered what would become known as the human immunodeficiency virus – HIV.

In the face of great challenges that faced those helping the HIV/AIDS community at the time, Barre-Sinoussi persisted and was a tireless and outspoken activist committed to fighting the disease in resource-limited countries. Barre-Sinoussi went on to help organise the very first International AIDS Conference in 1986 and just a few years later, she formed the International AIDS Society along with her colleagues.

“I went back to KZN to forgive (my mother’s) killers. They were never arrested. I see them every day. I feed their kids. What makes me happy is that their kids will never experience what I did.” – GUGU DLAMINI’S DAUGHTER, MANDISA DLAMINI

Arguably the biggest challenge to people living with HIV, and for those advocating for them, is stigma and discrimination, which endures even today. Our second woman, Gugu Dlamini, was fighting against this stigma over 20 years ago. Dlamini was a volunteer field worker for the National Association of People Living with HIV/AIDS in South Africa and she went public with her HIV status on World AIDS Day in 1998, in an attempt to challenge the extreme prejudice against people with HIV. Not long after this, Dlamini was murdered by her neighbours in retribution for the supposed shame she dad brought on their community.

The killing was as a major setback for HIV/AIDS activism, as advocates became afraid to publicly disclose their status. Decades later, the stigma associated with HIV has certainly lessened, especially as treatment options have improved. However, this prejudice is still present and continues to be a significant challenge to the daily lives of people living with HIV and those trying to educate the public on the disease. Dlamini’s name stands tall in the fight against discrimination, and in 2010, her daughter Mandisa founded the Gugu Dlamini Foundation to continue her mother’s fight against HIV/AIDS and gender violence.

“It was considered an amazing breakthrough that moved very quickly. It showed that one could develop a treatment against what now we know was a virus, HIV; that that could be done. Therefore, it was a critical step showing that one could actually get at the cause of the disease HIV and actually treat it itself, and begin to reverse it.” – MARGARET FISCHL

There are a variety of different HIV treatments available today – but the road to developing and gaining access to them was a long one – it took nearly 7 years for the first anti-HIV drug to be approved by the U.S Food & Drug Administration.

Margaret Fischl, a physician-scientist, was one of the first researchers to discover that the antiretroviral medication azidothymidine (AZT), an unsuccessful anti-cancer drug candidate, was effective at treating HIV.

The development of AZT to treat HIV was met with controversy as the FDA fast-tracked the drug’s review process despite massive public pressure against the trial. The trial, which involved 300 HIV positive participants receiving either AZT or a placebo, was stopped early due to strong positive results. Yet despite this the public battle continued due to controversy and mistrust around the  development of the drug.

Margaret Fischl became known as the ‘face’ of AZT as she fought to calm public opinion and provide reassurance. Despite strong public criticism and scrutiny, Fischl dedicated her life to educating the public on HIV/AIDS and was one of the first people in America to warn doctors and politicians of HIV’s potential to become a global pandemic and to identify the risk of heterosexual transmission.

In the more recent era we continue to see women scientists, clinicians, advocates, community and public health specialists who continue to innovate, inspire and lead in extraordinary ways – Sharon Lewin (Australia), Nittaya Phanupak (Thailand), Vuyiseka Dubula-Majola (South Africa), Beatriz Grinsztejn (Brazil), Glenda Gray (South Africa), Susan Buchbinder (USA), Rochelle Walensky (USA), Laura Waters (UK), Yvette Raphael (RSA), Helen Rees (RSA), Chloe Orkin (UK).

The list is endless and there are many more.