Over the last few years, microbicides have become a hot topic in HIV prevention. If microbicides become available, they would provide the more protection against HIV during sexual intercourse, both vaginal and anal. While microbicides would not replace condoms and sex education, they would provide another way to reduce the number of new HIV cases.
Current Microbicide Development
Currently, there are no effective microbicides available on the market; however, researchers are continuing to investigate this new method of prevention. Simply put, microbicides are gels, films, creams, or suppositories that can be inserted into the vagina or rectum to help prevent sexually transmitted infections (STIs), including HIV.
Currently, the microbicides in development are exploring a number of pathways to reduce infection. There are four main ways that microbicides are being developed to work. The first group creates a physical barrier that prevents HIV from interacting with the cells that it would normally infect. The second group of focuses on increasing the natural defense mechanisms of the vagina. A third group prevents the replication of HIV once it enters the cells. A final class focuses on destroying HIV cells by striping them of their outer covering.
As of 2008, there are 23 microbicides currently in development. One of these, Carraguard, created by the Population Council, is in a Phase II trial in South Africa and Botswana. Others microbicides are being tested in India, Malawi, Tanzania, and Zimbabwe. The results of these first trials should be available in 2009.
Once an effective microbicide is created, it will become available for sale either by prescription or over-the-counter. A number of groups, including the World Health Organization (WHO), would advocate for over-the-counter distribution, since it could then be distributed in the same fashion as condoms. This would allow access by individuals living in rural areas without access to clinics and pharmacies.
Potential for Worldwide HIV Prevention
A cost-benefit analysis done by the London School of Hygiene and Tropical Medicine found that if a microbicide that reduced the risk of infection by 40% was introduced in 73 lower-income countries at 30% coverage, it would be able to prevent about six million new HIV infections over a three years period. The resulting reduction in health care costs would be about $3.2 billion.
Benefits of Using Microbicides
Microbicides offer a number of benefits over other existing prevention techniques. In many developing countries, women are unable to ask their partners to use condoms. With microbicides, women could discreetly apply this product without asking their partner’s permission, allowing women to control their own sexuality.
References:
World Health Organizations. "Microbicides." 2008.
Global Campaign for Microbicides. "About Microbicides." 2008.
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