HIV Prevention using Microbicides

As we gear up for the upcoming HIV awareness month, I thought it would be great to share a new form of contraception. Microbicides, currently still in the research phase, could possibly be used to lower the risk of acquiring HIV in women.

The Microbicide Trials Network (MTN) is leading the National Institutes of Health-funded study in which SPL7013 Gel, or Viva Gel, is being tested for the first time in sexually active young women to determine the product’s safety, acceptability and ease of use. The expanded safety study, known as MTN-004, is being conducted at the University of South Florida in Tampa and the University of Puerto Rico in San Juan through collaboration between the MTN.

Vaginal microbicides are applied topically to the surface of the vagina and are designed to reduce or prevent the sexual transmission of HIV and other sexually transmitted infections. A microbicide can be formulated in many ways, such as a gel or cream. Several microbicide products are being tested in clinical trials, although none is yet approved or available for use by women. VivaGel is thought to act by hampering the ability of HIV to attach to and infect healthy cells. Unlike other candidate microbicides, including those that target similar cell mechanisms, the active ingredient of VivaGel, belongs to a class of compounds called dendrimers. A dendrimer is a large molecular structure that incorporates multiple units of an active component on its surface. In the case of SPL7013, each dendrimer incorporates 32 copies of the active component. Researchers will assess the safety of VivaGel compared with the placebo gel through laboratory tests and regular clinical examinations of study participants. (Baeten, Wang, & Celium, 2005) Web-based questionnaires are used to  provide information about the product’s acceptability, such as what participants liked or disliked about using the gel, how their sexual partners felt about its use and how likely they are to use microbicides in the future. Participation in the study will last three weeks, including the two-week period that gels are used.

As of 2007 there are 33-million people globally living with reported HIV.  Approximately 15.5 million HIV patients are women whom have reported their status to a health department. In Sub- Saharan Africa 22 million people are held reported to have contracted HIV and in Middle East and North Africa roughly 380,000 people have been reported to have HIV. In eastern and Western Europe almost 1.6 million people have been newly affected victims of HIV.  (www.UNAIDS.com 2007) To any health professional these numbers would be alarming and they should alarm us all. The question is how we prevent these numbers from escalating without offending other countries and their cultural activities as it relates to intercourse. Researches saw a need to help these women so they studied a molecule known as SPL7013 gel otherwise known Microbicides.

Imagine if your right to say “No” to sex was taken away from you, rape charges were not considered a crime in your country, and your husband has the right to sleep with people outside your marriage. Adding insult to injury, you are now a newly infected woman with HIV who had no control over the circumstances that have altered your life for years to come. For many women of southeastern Europe and Africa this is the culture of the countries they live in and they have no right to determine if they want to be in contact with this disease. Some people may argue that this issue is very much prevalent for women in our own country here in the United States. The difference that sets this culture apart however is that in some parts of Africa and Europe the men residing in these countries choose to participate in intercourse and not use lubrication which could possibly cause lacerations and tears to a woman’s vaginal wall. In return it makes the women whom are the receiving partner more susceptible to contracting the Human Immunodeficiency Virus otherwise known as, HIV.

To understand why this is such a big problem for receiving partners in these countries and surrounding countries, we first need to understand what HIV is and how it affects the body.  The immune system is a network of complex cells, tissues, and organs that communicate with each other to keep pathogens from invading the body. When this system fails to operate successfully, virus, bacteria, and fungi can invade our body and cause damage to tissues and organs that can lead to permanent damage or if left untreated can cause death. HIV is transmitted through blood, bodily fluids, (semen and vaginal secretion), and breast milk. This can occur through vaginal, anal and oral forms of sex, shared use of needles, birth, and breastfeeding. Lymphocytes, which are cells of the immune system, respond to the virus. T-lymphocytes commonly known as T-cells are the cells in the immune system that the HIV virus attack and destroy

“It’s important to study this  gel in young women who are sexually active because this is the very population likely to use and benefit most from this kind of HIV prevention approach,” said Ian McGowan, M.D., PhD., professor of medicine, Center for Prevention Research at the David Geffen School of Medicine, University of California, Los Angeles. “If we are satisfied with the results in terms of the gel’s safety profile we may consider conducting trials that would include more women, and eventually, look to see if the gel can help reduce their chances of acquiring HIV,” added Dr. McGowan, who, in addition to serving as protocol chair of the MTN-004 study, is MTN co-principal investigator.(Baeten, Wang, & Celium, 2005)

The Gel can be used with a contraceptive such as the Nuvaring . As the study is in research phase, scientist are trying to find a gel that dries, yet still active for women in countries where the mate prefers dry intercourse which transcends the high risk of acquiring HIV.

For more information you can visit: www.UNAIDS.com, www.Microbicides.org or www.USAID.gov

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