‘Women more at risk of HIV in pregnancy, during breastfeeding’

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Women are two to three times more at risk of getting infected with HIV, researchers involved in the Makerere University – John Hopkins University (MUJHU) Research Collaboration have revealed.

According to Dr. Phionah Kibalama Ssemambo, this risk is even higher among breastfeeding women, who are four times more at risk of infection compared to their nonbreast-feeding counterparts.

Kibalama who was addressing journalists at a meeting at MUJHU on Tuesday, said that women in Uganda are estimated to spend an average of ten years of their life either breastfeeding or pregnant, which gives them more exposure to HIV yet until recently this category of women were not permitted to take part in research that seeks to introduce new prevention interventions and therefore remain largely unprotected.

Another researcher, Dr Sheila Bamweyana says that not involving these women as participants in such research has been problematic. Dr. Bamweyana gives an example of a study in which they were testing the effectiveness of cabotegravir long-acting injection for HIV prevention.

She notes that while women participants were initially required to be using a birth control method or not pregnant, many still conceived. They recorded 50 pregnancies and 54% of them had been delivered or aborted by the end of the study. None of them had any congenital abnormalities, something that according to her shows it may be safe for such women to be involved in such trials.

The doctors are now pushing to have more pregnant women and breastfeeding mothers participate in clinical trials. Sharing her experience working on the dapavirine Vaginal ring that has been introduced for general use as an HIV prevention method following approval by World Health Organisation in 2021, Dr. Brenda Gati one of the researchers in the study said they tested the ring among exclusively breastfeeding mothers.

Dr. Gati said they compared the ring with oral drugs that women would swallow to prevent HIV and no drug was detected in the breast milk. Although she notes some infants were found to have traces of the dapivirine drug released by the vaginal ring in their blood.

However, while researchers are pushing for more women–centered HIV prevention interventions, adoption of the same including for women who are not pregnant or breastfeeding has been low. The davipirive ring whose research was done in Uganda more than ten years ago has not yet been rolled out for general use despite being approved by WHO and other global regulators.

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