By Lisa Collier Cool | Posted July 30 2010
In what could be a major scientific breakthrough, a study in South Africa has shown for the first time that a vaginal microbicide gel can significantly cut HIV infection in women. The CAPRISA 004 Trial is part of a global effort to develop effective prevention methods for women, who account for 60 percent of the newly infected in Africa, with young women at greatest risk. The findings were announced at the XVII International AIDS Conference in Vienna last week.
In the trial, women who used a vaginal gel containing tenofovir—an antiretroviral drug commonly used to treat HIV—were 39 percent less likely overall to become HIV-infected during sex than those who used a placebo. Women who applied the microbicide most consistently during the nearly three-year study had a 54 percent drop in HIV risk. The gel was also 51 percent effective at preventing genital herpes, the study by CAPRISA, a Durban, South Africa AIDS research center, found. That could further slow the spread of HIV, since people with genital herpes are twice as likely to contract HIV. The trial involved 889 sexually active South African women, ages 18 to 40, from AIDS-ravaged communities, where they were at high risk for HIV. About half of the women were given vaginal applicator of tenofovir gel and the rest got a look-alike placebo without the drug. The gel was inserted before and after sex. All study participants received free condoms and counseling on prevention of HIV and other sexually transmitted diseases.
Microbicides are compounds intended to block or reduce transmission of HIV when applied topically. Although the gel appeared to be safe and effective in the study, further research is needed to confirm these findings. Even partial protection would be a huge victory in South Africa—where one out three women is infected with HIV by age 20—potentially averting 1.3 million infections over the next 20 years, estimates study co-author Dr. Salim S. Abdool Karim.
However, it will be several years before the safety and effectiveness of this still-investigational gel is known and it the gel is approved for sale in South Africa and other countries. If mass-produced, it’s likely to cost less than 25 cents per application. No microbicides are currently available to the public, but scientists around the world are studying several types.
Connect the Dots
To learn more, go to AVERT (an international AIDS charity with articles on HIV prevention), the Centers for Disease Prevention’s HIV/AIDS page, and Global Strategies for HIV. For details about the anti-HIV gel study, visit CAPRISA (Centre for the AIDS Programme of Research in South Africa).
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