T

here is a saying in South Africa: Wathint’ abafazi, wathint’ imbokodo. You strike the women, you strike the rock.

On International Women’s Day, we want to celebrate the strong women who have always been at the heart of fighting the HIV/AIDS epidemic. For more than 35 years, women have modeled strength and resilience as researchers, nurses and physicians, caregivers, volunteers, advocates, social workers, and community leaders.

As the HIV/AIDS pandemic unfolded, women also became one of the most affected populations. Women now represent half of the people living with HIV around the world.

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To end this pandemic, women are advancing research on the front lines as scientists in laboratories and clinics and as leaders of large, international clinical trial efforts. Women are also making a difference in clinics around the world as participants in clinical trials, volunteering to help us better understand and fight the disease, one person at a time.

Women are setting examples, breaking down barriers, and demonstrating the value that inclusivity brings in scientific research. Because of their efforts, more trials will ensure that the unique biology of women is taken into account as new HIV treatment and prevention tools are developed, tested, and ultimately used by both sexes.

The participation of young women will be essential for testing a new HIV vaccine in the recently launched HVTN 702 study, the only currently active HIV vaccine efficacy trial in the world. It aims to enroll 5,400 women and men between the age of 18 and 35 in South Africa. Another 1,500 young women will participate in the antibody-mediated prevention studies, in which HIV-negative participants receive intravenous infusions of anti-HIV antibodies to see if this new approach can reduce their risk of becoming infected with the virus.

Women living with HIV are playing an important role in helping all people with the disease as participants in the REPRIEVE trial. This ambitious study, funded by the National Institutes of Health, was launched in 2015. It aims to determine if taking a cholesterol-lowering statin drug can reduce the risk of cardiovascular disease among people with HIV. Women living with HIV are three times as likely as their HIV-negative counterparts to develop heart disease; men with HIV are up to twice as likely. Trial investigators, attuned to the disparities affecting women in clinical research, are enrolling a racially and ethnically diverse group of women alongside men in five countries.

One of the most critical issues facing women at risk of contracting HIV in many parts of the world is the lack of prevention tools they can discreetly use, without needing to negotiate protection with a male sexual partner. More than 3,500 women in sub-Saharan Africa helped test a vaginal ring infused with an anti-HIV drug in two separate trials. Both studies showed that the ring provided modest protection from HIV infection. Women continue to use the rings in follow-up studies, helping scientists learn how this prevention strategy fits into women’s lives, how well it protects against HIV, and the complexities women face when relying on such a product.

The fight against HIV/AIDS has always been an ambitious challenge. As HIV researchers, we see every day how our work to end this pandemic depends on strong women. We have met countless women along this journey who have given unconditionally, volunteering their time, their bodies, and their hope to drive the scientific process. We thank and salute them.

Linda-Gail Bekker, MD, is president of the International AIDS Society and co-director of the Desmond Tutu HIV Center at the University of Cape Town, South Africa. Anthony S. Fauci, MD, is director of the National Institute of Allergy and Infectious Diseases, which is part of the National Institutes of Health.

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