title: Asking the right questions: developing evidence-based strategies for treating HIV in women and children.
abstract: In July 2010, the World Health Organization (WHO) issued formal revisions of its guidelines on the use of highly active antiretroviral therapy for HIV. The new guidelines greatly expand eligibility for treatment of adults and children, as well as for pregnant women seeking prophylaxis for vertical HIV transmission. WHO's new recommendations bring the guidelines closer to practices in developed countries, and its shift to earlier treatment alone will increase the number of treatment-eligible people by 50% or more.Scaling up access to HIV treatment is revealing important gaps in our understanding of how best to provide for all those in need. This knowledge gap is especially significant in developing countries, where women and children comprise a majority of those living with HIV infection. Given the magnitude and significance of these populations, the International AIDS Society, through its Industry Liaison Forum, prioritized HIV treatment and prophylaxis of women and children. In March 2010, the International AIDS Society and 15 partners launched a Consensus Statement outlining priority areas in which a relative lack of knowledge impedes delivery of optimal prevention of mother to child transmission (PMTCT) and treatment to women and children.The Consensus Statement, "Asking the Right Questions: Advancing an HIV Research Agenda for Women and Children", makes a special appeal for a more gender-sensitive approach to HIV research at all stages, from conception to design and implementation. It particularly emphasizes research to enhance the understanding of sex-based differences and paediatric needs in treatment uptake and response. In addition to clinical issues, the statement focuses on programmatic research that facilitates access and adherence to antiretroviral regimens. Better coordination of HIV management with sexual and reproductive healthcare delivery is one such approach.We discuss here our knowledge gaps concerning effective, safe PMTCT and treatment for women and children in light of the expansion envisioned by WHO's revised guidelines. The guideline's new goals present an opportunity for advancing the women and children's agenda outlined in the Consensus Statement.
authors: Department of Epidemiology, Columbia University, New York, USA.
authors: Quarraisha Abdool
authors: QA
authors: Karim
authors: Anchilla
authors: A
authors: Banegura
authors: Pedro
authors: P
authors: Cahn
authors: Celia D C
authors: CD
authors: Christie
authors: Robert
authors: R
authors: Dintruff
authors: Manuel
authors: M
authors: Distel
authors: Catherine
authors: C
authors: Hankins
authors: Nicholas
authors: N
authors: Hellmann
authors: Elly
authors: E
authors: Katabira
authors: Sandra
authors: S
authors: Lehrman
authors: Julio
authors: J
authors: Montaner
authors: Scott
authors: S
authors: Purdon
authors: James F
authors: JF
authors: Rooney
authors: Robin
authors: R
authors: Wood
authors: Shirin
authors: S
authors: Heidari
references: BMC Public Health. 2007 Apr 25;7:63
references: 17459154
references: Pediatrics. 2010 Feb;125(2):e250-60
references: 20083530
references: Trop Med Int Health. 2010 Aug;15(8):934-44
references: 20561308
references: Menopause Int. 2008 Dec;14(4):163-8
references: 19037065
references: J Womens Health (Larchmt). 2008 Jan-Feb;17(1):47-55
references: 18240981
references: AIDS. 2007 May 11;21(8):1019-26
references: 17457096
references: HIV Med. 2010 Nov;11(10):650-60
references: 20659176
references: J Acquir Immune Defic Syndr. 2005 Oct 1;40(2):161-8
references: 16186733
references: AIDS. 2008 Oct 18;22(16):2165-77
references: 18832880
references: J Acquir Immune Defic Syndr. 2008 Apr 15;47(5):566-9
references: 18197120
references: AIDS. 2010 Feb 20;24(4):515-24
references: 19996939
references: AIDS. 2009 Jun 19;23(10):1235-43
references: 19424054
references: J Antimicrob Chemother. 2007 Oct;60(4):724-32
references: 17715125
references: Contraception. 2008 Feb;77(2):84-90
references: 18226670
references: Pediatrics. 2007 Apr;119(4):e900-6
references: 17353299
references: J Endocrinol Invest. 2009 Jan;32(1):85-90
references: 19337023
references: BMC Infect Dis. 2010 Jun 24;10:188
references: 20576111
references: Cardiovasc Toxicol. 2004;4(3):271-9
references: 15470274
references: N Engl J Med. 2010 Jun 17;362(24):2271-81
references: 20554982
references: N Engl J Med. 2008 Nov 20;359(21):2233-44
references: 19020325
references: Ther Drug Monit. 2010 Jun;32(3):273-81
references: 20445485
references: Trop Med Int Health. 2010 Jul;15(7):833-41
references: 20487430
references: J Int AIDS Soc. 2010 Jun 23;13 Suppl 2:S2
references: 20573284
references: Sex Transm Infect. 2010 Dec;86 Suppl 2:ii48-55
references: 21106515
references: AIDS. 2007 Mar 12;21(5):607-15
references: 17314523
references: N Engl J Med. 2010 Oct 14;363(16):1510-20
references: 20942667
references: Pediatr Infect Dis J. 2010 Aug;29(8):721-7
references: 20539252
references: AIDS. 2008 Sep 12;22(14):1815-20
references: 18753864
references: Soc Sci Med. 2009 Sep;69(6):869-76
references: 19540644
references: AIDS. 2005 Mar 25;19(5):463-71
references: 15764851
references: Pediatrics. 2009 Dec;124(6):e1189-97
references: 19933732
references: AIDS. 2007 Jan 2;21(1):85-95
references: 17148972
references: J Womens Health (Larchmt). 2006 Mar;15(2):173-81
references: 16536681
references: N Engl J Med. 2010 Jun 17;362(24):2282-94
references: 20554983
references: J Acquir Immune Defic Syndr. 2005 Nov 1;40(3):364-70
references: 16249713
references: J Infect Dis. 2005 Mar 15;191(6):825-9
references: 15717255
references: N Engl J Med. 2006 Nov 30;355(22):2283-96
references: 17135583
references: PLoS One. 2010 Nov 09;5(11):e13891
references: 21085479
references: AIDS. 2003 Aug 15;17(12):1769-85
references: 12891063
references: J Infect Dis. 2008 Apr 15;197(8):1145-55
references: 18476293
references: J Acquir Immune Defic Syndr. 2007 Sep 1;46(1):62-7
references: 17667341
references: Br J Clin Pharmacol. 2008 Aug;66(2):179-95
references: 18537960
references: Lancet. 2010 Jun 5;375(9730):1948-9
references: 20569827
references: J Acquir Immune Defic Syndr. 2011 Feb 1;56(2):151-65
references: 21084993
references: Clin Infect Dis. 2010 May 15;50 Suppl 3:S130-48
references: 20397941
references: Trop Med Int Health. 2009 Mar;14(3):288-93
references: 19187522
references: BMC Int Health Hum Rights. 2010 Sep 13;10:23
references: 20836859
references: Clin Perinatol. 2010 Dec;37(4):825-42, x
references: 21078453
references: Pharmacol Res. 2008 Sep-Oct;58(3-4):173-82
references: 18708144
references: AIDS. 2007 Aug 20;21(13):1771-7
references: 17690576
references: Infect Dis Obstet Gynecol. 2009;2009:456717
references: 19893751
references: Am Fam Physician. 2000 Apr 1;61(7):2265
references: 10779261
references: J Acquir Immune Defic Syndr. 2011 Feb 1;56(2):e45-8
references: 21084998
references: Environ Mol Mutagen. 2007 Apr-May;48(3-4):159-65
references: 17358025
references: Lancet Infect Dis. 2008 Aug;8(8):477-89
references: 18652994
references: Drug Discov Today. 2008 Jun;13(11-12):530-5
references: 18549980
references: AIDS. 2010 Jul 31;24(12):1937-44
references: 20502314
references: N Engl J Med. 2010 Oct 14;363(16):1570-2
references: 20942674
references: Trop Med Int Health. 2010 Sep;15(9):992-9
references: 20561313
references: AIDS. 2007 Apr 23;21(7):835-43
references: 17415038
references: Soc Sci Med. 2009 Sep;69(6):846-53
references: 19573965
references: N Engl J Med. 2007 Jan 11;356(2):135-47
references: 17215531
references: Environ Mol Mutagen. 2007 Apr-May;48(3-4):210-4
references: 17358028
references: AIDS. 2009 Mar 13;23(5):597-604
references: 19194272
references: AIDS. 2009 Jul 17;23(11):1377-82
references: 19448528
references: J Acquir Immune Defic Syndr. 2003 Jun 1;33(2):175-83
references: 12794551
references: J Acquir Immune Defic Syndr. 2010 Jan;53(1):154-7
references: 20035168