Statistics on HIV/AIDS in Africa show that the scourge is not being controlled by advocating safe sex practices. Women are at a particular disadvantage if they are dependent on men who are unfaithful and refuse to use condoms – so often the case in poverty-stricken areas. The microbicidal gel, developed and tested in a large study in South Africa, from 2007-2010 showed a 39% protection against HIV infection. The microbicidal gel places the woman in control of prevention of HIV infection.
In 2001 the Centre for the AIDS Programme of Research in South Africa (Caprisa) , headed by Dr Salim Abdool Karim and his wife, was approached by leaders of the community of Vulindlela for help with their devastating AIDS problem. Vulindlela is a poor community in the rural Natal Midlands in South Africa.
The HIV Prevention Study
Initially an AIDS research and treatment centre was established. Field studies showed that new HIV infections were particularly high amongst young women. This prompted the search for a method which women could use to prevent infection.
The trial with the microbicidal gel containing 1% Tenofovir, one of the drugs used in treating AIDS, was launched in 2007 and after three years the results were announced at the XVIII International Aids Conference in July 2010. A total of 900 uninfected women were included in the study. Half were given the gel with Tenofovir and the other half gel without the drug, while not knowing which gel they received. (A double-blind randomised controlled trial). The gel had to be used within 12 hours before sex and again within 12 hours after. All the women in the study were also given safe sex counselling and condoms. The study participants were followed up and interviewed on a monthly basis.
HIV Study Results
The research trial lasted 30 months and it was found that there was a 39% lower incidence of HIV infection in the women using the gel. This increased to 54% for those women with high adherence to gel use (80% or more of the time). Further good news was that the gel appeared also to reduce genital herpes, that no significant side-effects were found and those who did become infected with HIV did not develop a resistance to Tenovir.
A 39% protection may not seem such good news but the finding must be placed in the context of the worldwide search for ways to prevent HIV, including the search for vaccine, which has occupied researchers since the virus was isolated 27 years ago. This is the first biomedical intervention for the prevention of HIV which has been successful. Eleven studies with six other microbicidal gels did not find an effective product.
Empowerment of Women
Dr Abdool Karim stressed in TimesLIVE: “Tenofovirgel is a unique HIV-prevention tool because it can be used and controlled by the woman. No such product is currently available.”
Sadly the gel is not going to be generally available soon because, as with all medical research, the results have to be confirmed with further independent studies and application made for the drug to be registered.
References
Karim, QA;Karim, SSA et Al. “Effectiveness and Safety of Tenofovir Gel, an Antiretroviral Microbicide, for the Prevention of HIV Infection in Women.” Science. Accessed on 2010/07/28
Karim, SA. 2010 “Breakthrough gel helps women fight HIV” Times LIVE. Accessed on 2010/07/28.
Frieda Paton - A published nurse author, Frieda has variety in her life being a part-time nurse, business owner and craft producer.
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