Scientists are now close to eliminating mother-to-baby transmission, says the lead researcher

Quaraisha Abdul Karim has spent the last three decades studying HIV and AIDS. She has become one of the world’s leading epidemiologists and has made a major contribution to the global understanding of how HIV affects young women.

As Associate Director of the Center for the AIDS Research Program in South Africa (CAPRISA), Abdul Karim has been honored by scientific organizations around the world for her groundbreaking research on HIV prevention.

She said SciDev.Net that rapid progress against the disease means that scientists are now close to eliminating transmission from infected mothers to babies, which was about 30 to 40 percent.

You have been testing for HIV for 30 years. How much more do we know now about the virus that causes AIDS, what causes it in the body, and how do we help women fight it?

AIDS was inevitably fatal and is now a chronic, treatable condition due to a combination of factors. We now use the most modern drug combination to treat AIDS patients. The researchers were able to develop antiretroviral drugs (ARVs) and understand the combination of antiretroviral drugs that allowed us to control viral replication. We have not stopped viral replication in humans, but we are able to control it so that they can live a normal and healthy life.

Previously, we had rates of transmission from infected mothers to babies of about 30 to 40 percent. We are close to eliminating such a transmission. There were a number of children who died before the age of five, but now we see that the growing number is reaching adolescence.

But when it comes to preventing HIV infection, especially sexually, it remains a challenge. When you talk about the risk of sex … it’s a very touching question. There are many moral nuances in this. So “science” is just the beginning. It provides it to the people who need it – after all, this is the importance of science to me.

How close are we to having a tool for women to be able to prevent HIV? One that is reliable and long-term?

From a scientific point of view, this is perhaps the most exciting era. In 2010, we shared the results of a study we started in 2006 to evaluate a topical ARV-based remedy – tenofovir gel – used by women for sex, and it showed for the first time that we can prevent infection with antiretroviral drugs. We also talk about it as “pre-exposure prophylaxis” or PrEP. So this is something that exists today and is available to women and men at risk.

Most of the new studies are about two-month injections, or six-month injections, or implants that can potentially be used all year round, or a tablet that can be taken once a month. One study was completed on a two-month injection, which has really exciting data. So, what we see in the prevention landscape for men and women is a menu of options. But especially for women, they are very similar to contraceptives.

One thing that impresses me is that you may have science, but that doesn’t always fight rhetoric. People may simply choose not to believe what you say. How do you deal with this?

In dealing with COVID-19, as well as HIV, we are not unique and isolated. But whether you denied it or not, we were vulnerable and the virus spread. Same with COVID-19. This is a pandemic. This means that globally we are all vulnerable and have seen countries where leadership has disappointed the public. And the reality is that none of us is an island.

But there are also problems with trust. And whether it’s trust in science and scientists and the medical fraternity, or whether it’s trust in government, they all come together. Many of the problems around hesitation and mistrust and so on, what we see in COVID-19, are not isolated from other things that happen.

You currently wear so many hats, what are you most proud of when you think about your career?

As a scientist, he is not only concerned with science. One also addresses the issue of teaching and public engagement; this really came to the fore. Much of the science I did was informed by growing up in South Africa with apartheid and activism. And so to demystify things, to make sure that the people you work with, and especially the communities and the participants in the research, actually understand what their rights are. And you have to remember your story in terms of where you come from and how you go, and that definitely shapes you.

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