Successful Microbicide Trial Prompts Questions About Future Research, Use

Main Category: HIV / AIDS
Also Included In: Sexual Health / STDs;  Women's Health / Gynecology
Article Date: 28 Jul 2010 - 3:00 PDT

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Following results of a trial in which a microbicide gel lowered a woman's risk of HIV by 39%, health experts are considering how to make the treatment more effective and what its applications might be, the New York Times reports (McNeil, New York Times, 7/26).

The findings represent the first successful results in a 15-year quest to find a method that can help women independently protect themselves from HIV infection during sex. After two-and-a-half years, women who used the microbicide gel -- which contained the antiretroviral drug tenofovir -- for roughly three-quarters of their sexual encounters had a 39% lower risk of HIV infection. Women who used the gel for at least four-fifths of their sexual encounters had 54% fewer infections (Women's Health Policy Report, 7/20).

Experts now face questions about how to improve the drug's efficacy, whether it might be used successfully in certain populations and how the treatment can be deployed to the public.

The gel in the study contained 1% tenofovir; some experts question whether a higher concentration could prove more effective. In addition, participants were instructed to use the gel before and after intercourse, prompting some experts to wonder if one application -- which would be more cost-effective and easier -- would also yield positive results.

Observers also question whether the drug could be used for certain groups of people. For instance, they question whether the gel will protect sex workers, who may have sex more frequently and with more men than the women in the study. Experts also question whether the gel could safely be used by pregnant women; researchers stopped providing the gel to women who became pregnant during the course of the study. In addition, researchers have asked whether the drug could be used for women or men who engage in anal sex.

Some experts are wondering how much more testing will be required for the treatment to win regulatory approval. The gel in the study cost two cents per dose, but the plastic applicator cost 40 cents per dose. Experts wonder if the cost can be reduced enough to ensure its use in low-income nations (New York Times, 7/26).

Reprinted with kind permission from http://www.nationalpartnership.org. You can view the entire Daily Women's Health Policy Report, search the archives, or sign up for email delivery here. The Daily Women's Health Policy Report is a free service of the National Partnership for Women & Families.

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