1st International Workshop on HIV and Women, 10-11 January 2011, Washington

Introduction: what took so long?

Thirty years into the history of the epidemic, the 1st International Workshop on HIV and Women was convened in Washington by Virology Education at the beginning of January 2011.

Many of the presentations underlined how little we know. In her talk on HIV Treatment in Women, Kathleen Squires reminded us that from 19871990 only 6.7% of the 11,909 participants in ACTG trials were women. Despite increased representation by women, most studies since 1990 lack statistical power to definitively answer many important questions. And a meta-analysis of antiretroviral registrational trials from 20002008, showed that only 20% of 22,411 participants overall were women.

The good news is that the number of HIV-positive women participating in trials is increasing although sex/gender based analyses are relatively uncommon. Most analyses show higher discontinuation rates in women, although the factors that drive this are unclear.

In the session on pharmacokinetics, Angela Kuasaba described what is important? with regards to drug exposure in women. Whether increased drug exposure may translate to better efficacy or more adverse events; dosing in pregnancy and post partum; interactions with progestins and oestrogens and oral and topical concentrations when using antiretrovirals in prevention all need to be better characterised.

Quarraisha Abdol Karim looked at where we are with microbicides and Glenda Gray at the challenges a woman faces in her lifetime living with HIV from adolescence, through pregnancy, ageing and menopause.

The slides from all the lectures are worth looking at for anyone wishing to learn about or get an update on the current state of the art.

Overall this meeting is a welcome addition to the conference calendar and will provide researchers with a dedicated forum to present their work (and perhaps drive more research), as there are still many unanswered questions. At the moment, making recommendations concerning HIV treatment and women is often an exercise in how many different ways can you say, there are no data.