Jul 18, 2019 | Updated: 09:53 AM EDT

Daily Survival is a Priority Over Viral Suppression for Many HIV+ Women

May 17, 2019 01:54 PM EDT

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Daily Survival is a Priority over Viral Suppression for Many HIV+ Women
(Photo : Image by Gerd Altmann from Pixabay)

Most times, statistics paint an impressionist view of the lives of these women that miss the granular detail that tells the real story, according to scientists who studied women infected with HIV. The imprecise big picture is that most of this population is doing a good job at suppressing the virus, but facts gathered on the ground reveal that many of them struggle with issues of daily living that can make taking a pill to keep HIV at bay difficult.

Researchers published their findings of the study in JAMA Network Open and they indicate that while a majority of the 1,989 HIV+ women they have been studying since 1994 have been able to control their virus, often on and off, challenges such as mental health, unstable housing, and lack of social support constitute ongoing barriers to effective and sustained viral suppression.

The first author of the study and an associate professor of medicine at Georgetown University Medical Center, Seble G. Kassaye, MD, MS, said that survival is a priority over putting a pill in your mouth for a number of their participants, and that is the public health challenge they need to address. She added further that the truth of their lives is a lot less rosy than a few lines of statistic in a summary report can reveal.

An infectious diseases clinician and epidemiology expert, Kassaye, is the principal investigator of the Washington Metropolitan site of the NIH-funded longitudinal cohort, the Women's Interagency HIV Study (WIHS), which has tracked many of the participants since it first opened in 1994. Four other sites of WIHS (two in New York, Chicago, and San Francisco) contributed data to this work.

They launched WIHS due to the recognition that HIV is nearly prevalent in women as in men, in some populations, and that the biology and route of infection can differ. One instance is in Washington DC, 1.9 percent of African American women are HIV+, compared to 4.4 percent of African American men. And 30 percent of HIV+ women who have been studied have no explanation as to how they become infected.

Though the treatment of HIV today is much less toxic than it used to be, and drug therapy is now suggested for infected individuals, and are therefore in much higher use, the barriers to daily treatment are real. The researchers discovered that women in the high viremia group were more likely to report depressive symptoms (54 percent) have higher levels of current illicit drug (41 percent) and alcohol use (14 percent), be less likely to have stable housing (66 percent) and were more likely to die prematurely (39 percent).

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