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The HIV Puzzle: How We’re Putting the Pieces Together to Help Stem Infections Among Young Girls and Women

USAID Southern Africa
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When many people think of innovation, they conjure images of whiz-bang technologies. But that’s only half the picture. If those technologies aren’t responsive to people’s needs, they won’t do any good. Innovation is most exciting when it marries hard science with social science to deliver practical solutions to big problems.

One of those big problems is the rise in HIV infections among adolescent girls and young women in sub-Saharan Africa. On the good-news front, the global community has, incredibly, significantly reduced the number of babies born with HIV to almost zero. The bad news, though, is that AIDS is still the leading cause of death among African women, and African girls are now at least twice as likely as African boys to contract the disease. In short, many HIV-free baby girls will grow up to be at great risk of contracting HIV when they’re teenagers, and without a deep understanding of the unique barriers girls face in protecting themselves, this trend will continue.

That’s why recent results from two large clinical trials showing that a monthly antiretroviral vaginal ring helped prevent HIV in women is such a breakthrough. This is an innovation that is sensitive to the context of women’s lives. Since using a vaginal ring is under a woman’s control, it gives her the power to protect herself in a way that access to condoms doesn’t.

The DREAMS partnership, of which Johnson & Johnson is proud to be a member, is a complementary kind of approach to addressing the crisis of HIV among girls and women. The partnership’s goal is to cut AIDS rates for adolescent girls in sub-Saharan Africa by 25 percent in 2016 and 40 percent in 2017.

The DREAMS partners know we can’t come up with all the answers, so we’ve solicited creative approaches that address not just the biology of HIV but also broader issues of girls’ health: keeping them in secondary school, for example, and providing bridges from school to employment. The goal is to get to the bottom of the social factors that make women and girls especially susceptible to infection.

We’re working on another recent advance that, while not focused specifically on girls and women, also moves innovation beyond the laboratory and into people’s real lives. In partnership with Viiv Healthcare, Janssen Pharmaceutical Companies is developing long-acting injectable antiretroviral drugs to treat HIV.

The current drug regimen available to people living with HIV involves taking pills at specific times every single day, a solution that works only if patients stick to it. A long-acting injectable, however, could make it easier for people to adhere to treatment and, in parts of the world where it’s difficult and expensive to get access to healthcare, long-acting HIV drugs could help patients save more money to invest in their family’s future.

One of the key principles driving these combined scientific and social innovations is Johnson & Johnson’s new focus on making sure our solutions are integrated with each other. In the past, many approaches to HIV—including ours—have focused on prevention, or education, or medicine, but we know now that none of these efforts works as well on its own as they all do together. It’s like a jigsaw puzzle: it isn’t complete until you put all the pieces together.

The thing that makes the innovations I’ve written about above so exciting is the wide range of approaches they demonstrate based on deep insights into the problem: they aim for prevention and treatment, for long-acting medicines that adapt to people’s lives (instead of the other way around), for methods that give women more control over their health.

Each of these approaches alone makes a difference, but taken together, they showcase the commitment, collaboration, and creativity that are going to help us win the fight against AIDS.

Jaak Peeters is the head of Global Public Health at Johnson & Johnson.

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