Microbicide for HIV Prevention Shows Promise

By Rachel Walden — July 21, 2010

Researchers, advocates and public policy experts have gathered in Vienna, Austria to discuss the latest scientific developments and other issues related to HIV/AIDS at the 18th annual International AIDS Conference.

The biggest news focus coming out of the conference so far is about tenofovir gel, a vaginal microbicide. Tenovir has been part of the CAPRISA trial conducted in South Africa, and has shown some promise in preventing HIV transmission. According to a press release from the trial:

The microbicide containing 1% tenofovir—an antiretroviral drug widely used in the treatment of HIV—was found to be 39% effective in reducing a woman’s risk of becoming infected with HIV during sex and 51% effective in preventing genital herpes infections in the women participating in the trial. Should other studies of tenofovir gel confirm these results, widespread use of the gel, at this level of protection, could prevent over half a million new HIV infections in South Africa alone over the next decade.

The search for an effective microbicide has been ongoing for quite a few years now, as it could represent an important woman-controlled tool for reducing HIV infection, especially when women may not be able to insist on condom use. This is the first time a microbicide product has really been considered to show major promise for prevention.

As the New York Times explains, however, additional work will need to be done before this product becomes widely available to women who might benefit from it:

Broader trials are needed to confirm the results, and it will most likely be years before the product is publicly available, but if produced on a large scale the gel would cost less than 25 cents per application…Because the trial was relatively small and the gel was nowhere close to 100 percent effective, AIDS scientists and public health officials wanted to see another trial get similar results before they undertook the large fund-raising and public education efforts that would be needed to make billions of doses of the gel, as well as the applicators, which are more expensive, and then to persuade women to use them and governments of poor countries to adopt them.

Science magazine has made a paper with scientific details on the trial freely available to the public. The conference blog provides a number of relevant resources for those interested in learning more about this research.

Last night’s PBS Newshour had an interview with Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases (part of the NIH), which I think did a great job of explaining the findings; a transcript of the video below is available online.

Also of interest is the Women ARISE coalition, consisting of international women’s groups and organizations whose stated mission is to:

…work together to galvanize and promote a common agenda on women and girls’ rights in the AIDS response and ensure that all women and women’s issues are central and visible in the objectives and program of the International AIDS Conference in Vienna.

The group’s founding document [PDF] outlines important principles and needs for addressing the concerns of women and girls in HIV/AIDS response efforts, including protecting and promoting the human rights (including reproductive and sexual rights) of women and girls, addressing violence against women as a cause and consequence of HIV, addressing sexual and reproductive health more broadly, developing the basic services needed by communities, including women’s leadership, and demanding accountability from the international community.

The International Women’s Health Coalition has also posted on the Women ARISE initiative in their post, Outspoken Women in Vienna Demand Rights and Inclusion, reporting directly from the conference on a demonstration at the conference plenary session intended to make it “clear that the only way to end this epidemic is through gender equality, empowering women, fulfilling our sexual and reproductive rights and health, and providing all young people with comprehensive sexuality education.”

Readers can get updates from the conference on Twitter (@aids2010), on Facebook, and on the conference blog.

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