HIV and Microbicides

There’s a “novel delivery system” in the prevention of HIV in women according to a 2010 report published by the HIV and Aids Review from the Polish AIDS Research Society.

The report, which was made publically available online at the beginning of 2011, reveals a study done by the Center for AIDS Programme of Research in South Africa (CAPRSA) that showed the correct use of a sexual lubricant containing Tenofovir microbicide reduced the transmission by 54 percent in comparison to a placebo.

Medical experts believe that the gel could prevent as many as 1.3 million HIV infections in women and 820,000 HIV-related deaths in South Africa alone. The numbers are estimated over a time frame of 20 years. Worldwide the number of HIV cases that could be prevented goes in the multiple millions.

Medscape Medical News reports that the gel lubricant also reduced the risk of genital herpes infections, also known as HSV-2.

The results of the study were announced at the AIDS 2010: XVII International AIDS Conference. The announcement received applause three times including a standing ovation.

More Information About Microbicide Vaginal Gel

The vaginal gel used in the rigorously controlled clinical studies contains one percent Tenofovir microbicide. It’s an antiretroviral medication, also sold in tablet form, that stops HIV from duplicating inside a person’s cells.

Background to the Microbicide Study

Study into the use of microbicide vaginal gel in the prevention of AIDS has been in the process for a number of years. The breakthrough announced in 2010 presented the results of the phase 2b of the placebo-controlled, randomized, double-blind study into the medical gel.

Credited with the discovery and creation of the gel are two South African doctors: Quarraisha Abdool Karim, PhD and Salim Abdool Karim, MD, PhD. Quarraisha Abdool Karim is an associate professor of clinical epidemiology at the Mailman School of Public Health of Columbia University in New York City. Salim Abdool Karim is a professor of clinical epidemiology at the same university. The professors have affiliations at the CAPRISA at the University of KwaZulu-Natal in Durban, South Africa.

The study into the microbicide gel was funded by the National Institutes of Health (NIH).

Study Details

There were 889 sexually active HIV-seronegative women enrolled by CAPRISA 004 in the study from the rural and urban areas in KwaZulu-Natal. Of the 889 enrolled, 843 completed the entire study.

The women inserted a prefilled applicator of gel up to 12 hours before having sexual intercourse. They didn’t know if they were using a placebo-filled applicator or one containing the one percent Tenofovir microbicide gel. They were then instructed to insert the applicator again as soon as possible after sex, within 12 hours.

Women participated in the trial for at least one year for a maximum of two years.

They also received HIV risk-reduction counseling monthly as well as condoms and treatment for other sexually transmitted infections.

Study Results

Results as to the effectiveness of the study vary. According to the report in HIV and Aids Review the medicinal vaginal gel reduced the transmission of HIV by 54 percent. Medscape Today News reports the number as 39 percent.

The numbers vary depending on if the gel was used correctly.

Dr. Quarraisha Abdool Karim said at the AIDS 2010: XVII International AIDS Conference: “Whichever way you analyze these data, we have a range of protection from 37 percent to 45 percent. Each of these analyses yields a statistically significant result.”

Women who used the gel 80 percent of the time they had sex showed an HIV-reduction rate of 54 percent. Those who used the gel 50 percent to 60 percent of the time they had sex saw a reduction rate of 38 percent. Women who used the gel less than 50 percent of the time they had sex saw a 28 percent reduction.

During the study, 60 women using the placebo became HIV positive and 38 women using the microbicide gel became HIV positive. Those who became infected did not have a virus strain that showed resistance to Tenofovir.

Leave a Comment