Gates Foundation Announces Grants for Studies of Diaphragms, Microbicides, Adult Male Circumcision as Methods to Prevent HIV Transmission
The Bill & Melinda Gates Foundation yesterday announced nearly $46 million in grants that will combine new uses of existing tools and procedures with the development of new products that may offer new approaches to both HIV prevention and contraception. Each of the newly announced grants "parallel" the recommendations the Global HIV Prevention Working Group issued in its July 2002 report. Dr. Helene Gayle, director of the foundation's HIV/AIDS and tuberculosis program and co-chair of the Global HIV Prevention Working Group, said, "These grants advance the strategy of combination prevention, attacking risk factors and risk behaviors in multiple, reinforcing ways. They also could provide greater options for women's protection against HIV and other STDs." Descriptions of the three grants appear below:
University of California-San Francisco's Women's Global Health Imperative: The foundation awarded the program -- which is jointly sponsored by UCSF's AIDS Research Institute and its department of obstetrics, gynecology and reproductive sciences -- a $28 million grant to continue testing the diaphragm as a method of preventing the spread of HIV and other STDs. WGHI intends to study the diaphragm's effectiveness among 4,500 women in Southern Africa. "In countries like Zimbabwe, we have a moral imperative not only to search for new products, but also to consider new uses for existing ones, " WGHI Director Nancy Padian said (Bill & Melinda Gates Foundation release, 8/28). The diaphragm's effectiveness in preventing HIV has never before been studied, but, according to the San Francisco Chronicle, "substantial biological evidence" suggests that protecting a woman's cervix from semen infected with HIV or other STDs could "significantly" reduce her risk of contracting the viruses. Padian, who has been looking for funding for the project for eight years, presented research at the XIV International AIDS Conference in Barcelona, Spain, indicating that women who could not convince their partners to wear condoms would use a diaphragm without their partners' knowledge. Women also indicated they would use a diaphragm to protect themselves from HIV (Russell, San Francisco Chronicle, 8/28).
Eastern Virginia Medical School's Contraceptive Research and Development (CONRAD) Program: The foundation awarded the program $11.9 million to research microbicides that are effective both as contraceptives and as a method of preventing the spread of HIV and other STDs. The grant will also fund the Global Microbicide Project's contraceptive clinical trials. "Microbicidal gels hold the promise of both disease prevention and contraception, each a vital need in developing countries," Michael Harper, director of the Global Microbicide Project and CONRAD's Consortium for Industrial Collaboration in Contraceptive Research, said. CICCR is also researching a potential injectable male contraceptive.
- Columbia University's Mailman School of Public Health: The foundation awarded $5.8 million to the school to support an ongoing study in Uganda examining adult male circumcision as a way to decrease HIV transmission risk. The grant will also allow the project to look at whether adult male circumcision reduces the risk for both men and women of contracting other STDs, whether HIV infection rates are reduced among women who partner with circumcised men and whether the spread of HIV and other STDs declines in populations where a "substantial proportion" of the men are circumcised. "If the potential beneficial effects of male circumcision on men and women's health are proven, the procedure has the potential to gain widespread acceptance and have a lasting effect on the health of entire populations," Dr. Maria Wawer, Columbia University professor of clinical public health and co-principal investigator on the study, said (Bill & Melinda Gates Foundation release, 8/28).