During sex, all women are unable to negotiate condom use. For them, hope may lie in the development of microbicide. After years of failure, a study presented at the international conference in Vienna concludes with positive results.
A projection made at the international conference against AIDS finds that the use of a gel with an efficiency of 40-50% could prevent 271 000-602 000 new HIV infections in South Africa in the next 10 years according to its distribution in the population.
Although moderately packed, the AIDES association also states that “The freeze is not a contraceptive. It can help protect themselves while conducting a project of parenthood. By cons, it will not be promoted as a planning tool” (…) “The use of a gel combined with a mastery of the viral load of HIV-positive partner, could represent a real step forward for the quality of life of HIV-discordant couples.
Basically, there are two types of microbicides:
- The first generation of microbicides are a physical barrier against HIV or alter the chemistry of the vagina in order to reduce the risk of infection.
- The second-generation microbicides are products with specific action against HIV, including antiretroviral drugs that use.
If the former have hitherto failed to obtain good results (some even having proved more harm than good because they would undermine the mucosa and promoted the penetration of the virus in the body), the latter remain your hope live and this year, a study on a microbicide containing an antiretroviral drug (tenofovir marketed under the name Viread ®) up to 1% that makes sense.
Press conference presenting the study CAPRISA
Begun in 2007, called CAPRISA trial included 004 889 women in South Africa from 18 to 40 years, currently uninfected but sexually active and at high risk of becoming infected. 445 women received the gel with anti-retrovirals and 444 frost free product. All were to use a dose of gel 12 hours before sexual activity and a second within 12 hours after the relationship. Each woman was followed every month for 30 months and advised on the use of the gel, but also prevention advice on condoms and their sexual lives. Results: HIV incidence was 54% lower among women who have consciously used the gel, 38% among those who used moderately and 28% among those who used it poorly (less than times two). Bonus: this gel also works vis-à-vis the herpes lowering the risk of contamination of 51%, good news because we know that this infection increases the risk of transmitting and acquiring HIV (even if in this study, this relationship has not been demonstrated, it seems that both preventive actions are independent).
Several questions still unanswered: Why do some women have been affected despite the use of tenofovir gel? How to improve adherence to this type of treatment? Preventive actions vis-à-vis HIV and herpes are they really independent or do they act in synergy? … This phase 2 study does not answer these questions today, only the Phase 3 trial underway involving over 4000 women will do.
Despite these unknowns, these results have been greeted with enthusiasm. “We welcome the good results of the study irregular. Any new step forward in HIV prevention, especially for women, is very interesting. We expect to see these results confirmed. Once they have demonstrated their efficacy and safety, WHO will work aveec countries and partners to accelerate access to these products, “said Dr Margaret Chan, Director General of the World Health Organization. Half of people living with HIV are women. In sub-Saharan Africa, yet they are more infected than men. To respond quickly, WHO and UNAIDS announce a forthcoming expert consultation in the month of August in South Africa to discuss the future of this product.