The NICHD focuses a great deal of its research on preventing STDs through methods that reduce risky behaviors, which are actions that can lead to the spread of STDs, in various populations. For instance, through its Demographic and Behavioral Sciences Branch (DBSB), the NICHD has supported the National Longitudinal Study of Adolescent Health (Add Health Study) since the early 1990s. The Add Health Study strives to understand the factors influence health and health-related behaviors, including sexual activity and STD/STI prevention, among adolescents. The Institute has also created several intervention programs that strive to understand the things that influence teens' decisions in regard to behaviors that may put them at risk for STDs, including HIV. Among these programs is the NICHD-sponsored Adolescent Medicine Trials Network (ATN) for HIV/AIDS Interventions for HIV/AIDS interventions, which conducts research, often in collaboration with other networks, on different ways to prevent HIV transmission among at-risk adolescents and on treatment for HIV-infected youth.
The Institute also conducts research on trends related to risky behaviors. For instance, some NICHD research revealed that teens who are infected with HIV/AIDS are more likely to also have another STD, such as gonorrhea. In one study, 77 percent of HIV-positive women also had HPV, and 15 percent of HIV-positive females also had hepatitis B virus. The NICHD co-funds the Women's Interagency HIV Study (WIHS), the largest and longest ongoing study of HIV-infected women. WIHS data are providing a great deal of information about STDs and the nature of risky sexual behaviors in this population.
Since 1987, the Institute has supported research and training activities that have helped to establish and define the field of contraceptive microbicides, products meant to prevent pregnancy and the transmission of STDs, including HIV. The NICHD's Contraception and Reproductive Health Branch oversees much of this research, including managing the Contraceptive Clinical Trials Network. In addition, through the Pediatric, Adolescent, and Maternal AIDS (PAMA) Branch, the NICHD also supports the Microbicide Trials Network to study the use of microbicides to prevent HIV.
NICHD-supported researchers are also trying to understand the best ways to communicate with people about STDs and preventing STDs. Some of this research includes studying attitudes, perception, and knowledge of STDs and how to prevent them; understanding the use, misuse, and misinformation that surround contraception as a way to prevent STDs; and identifying the best settings for providing STD and prevention information. Because preventing and treating STDs is a major research aim for the NIH, the NIH and its Institutes conduct and support a variety of clinical trials on STDs. The NICHD provides more specific information on STDs, including links to Web sites and other resources, at http://www.nichd.nih.gov/health/topics/sexually_transmitted_diseases.cfm. HIV/AIDS in Female Populations According to the Joint United Nations Programme on HIV/AIDS (UNAIDS), 19.2 million women are living with HIV/AIDS throughout the world. In many countries, the rate of HIV infection in women is rising faster than in any other group.
Worldwide, more than 80 percent of HIV infections are spread by heterosexual sex (vaginal intercourse); women are particularly at risk of contracting HIV through this type of contact.
Treatment advances have improved the survival rates and decreased progression of HIV disease for women and men with HIV infection and AIDS in developed countries like the United States, where antiretroviral drugs are available. The NICHD and other governmental and non-governmental organizations, are exploring ways to improve the availability of treatment in areas where it is currently not available or not reliably available.
However, women have complex family issues and multiple life problems that they often put before their own HIV treatment. Because women are often the primary caregivers for the family, HIV infection and its associated problems affect not only the lives of women infected with HIV, but also the lives of their children and other family members, some of whom might also be infected with HIV. HIV-infected women may be poor, may lack social support, and may have difficulty accessing health care, which makes helping these women deal with societal pressures, as well as caring for those who are HIV positive more complex.
The NICHD, along with other Institutes, supports studies to determine what aspects of HIV are specific to women and how to best treat these factors. Some of this research includes the following studies: - Women's Interagency HIV Study (WIHS). This study, which is co-sponsored by the NICHD and four other NIH Institutes, is the largest and longest ongoing study of HIV-infected women. The NICHD's Pediatric, Adolescent, and Maternal AIDS (PAMA) Branch has been funding one of the six clinical sites for the WIHS since 1993. WIHS has enrolled more than 2,700 HIV-infected women and about 1,000 uninfected women. This study is trying to understand the unique ways HIV/AIDS affects women, the ways successful treatments for HIV/AIDS affect women, the relationship between HIV/AIDS and other diseases, such as hepatitis C virus infection, and the impact of hormonal factors on HIV disease. Most of the women enrolled in WIHS are women of color. For scientific articles on the WIHS findings, please visit https://statepiaps.jhsph.edu/wihs/index-publications.htm.
- For a listing of other HIV/AIDS projects supported by the NICHD, please visit http://www.nichd.nih.gov/about/org/crmc/pama/supported/index.cfm.
Reducing Mother-to-Child Transmission of HIV Mother-to-child HIV transmission is the major source of HIV infection in children. Without any type of intervention, mother-to-child transmission rates range from 15 percent to 30 percent (without breastfeeding), and can reach 30 percent to 45 percent if a woman breastfeeds for a long time. Studies have shown that mother-to-child transmission can occur: - During pregnancy and delivery. But, many researchers believe that most of the transmission during this time occurs in late pregnancy and during the birth process.
- From a mother to her breastfeeding child.
Much of the NICHD's research efforts in HIV/AIDS focus on developing ways to prevent HIV transmission, both through medical interventions with pregnant women, and by helping women avoid pregnancy. Through its research, the NICHD has helped make great progress in reducing the spread of HIV in these situations. In the United States, these rates dropped from 25 percent to under 2 percent as a result of discoveries made by NICHD researchers and their colleagues in medical and academic communities, and through the work of other NIH Institutes. For highlights of NICHD-supported research and research advances on reducing mother-to-child transmission of HIV, please select one of the resources below: HIV/AIDS Clinical Trials and Other Resources
The NIH is currently conducting many clinical trials related to HIV/AIDS. These trials are sponsored and co-sponsored by various Institutes, including the NICHD. For information on the sponsoring Institute(s), please read the description for a specific clinical trial. The NICHD International and Domestic Pediatric and Perinatal HIV Clinical Trials Network conducts clinical trials in children and HIV-infected pregnant women in collaboration with the NIAID-sponsored PACTG. Many sites in the NICHD Network also help enroll women into clinical trials to evaluate the treatment of female-specific HIV problems, in collaboration with the NIAID Adult AIDS Clinical Trials Group (AACTG). The NICHD-sponsored Adolescent Trials Network (ATN) for HIV/AIDS Interventions conducts research, often in collaboration with other networks, on various interventions to treat HIV infection and its complications in adolescents, ages 12 to 24, and interventions to prevent HIV transmission among at-risk adolescents. If you are HIV-positive, on antiretroviral therapy, and are currently pregnant, you can talk to your health care provider about being part of the Antiretroviral Pregnancy Registry. The purpose of this registry is to identify whether any of the antiretroviral therapies taken during pregnancy increase the risk of birth defects. If you enroll in the registry, your health care provider will report on the progress of your pregnancy to the registry after your prenatal appointments. Talk to your health care provider for more information. In addition, AIDSinfo, a project of the U.S. Department of Health and Human Services (DHHS), is the main source of information on federally approved treatment regimens and prevention guidelines for HIV infection and AIDS-related illnesses, including prevention of HIV transmission from job exposure, and from mother-to-child during pregnancy. Additionally, the AIDSinfo has a help line, at 1-800-HIV-0440 (1-800-448-0440); 301-519-0459 (International); 1-888-480-3739 (TY/TDD). This resource, open from 12:00 p.m. to 5:00 p.m. Eastern Time, Monday through Friday, is staffed by Health Information Specialists, who offer confidential responses to questions and assistance with navigating the Web site. Spanish-speaking specialists are also available. The Division of HIV/AIDS Prevention at the CDC also has patient information on these topics.
Please note that the resources above offer information about HIV/AIDS in all populations, not just in female populations. For information specifically related to pregnancy and HIV/AIDS, you may find the following resources helpful: |
