Kaiser Daily HIV/AIDS Report Summarizes Research Presented at Microbicides Conference
The Microbicides 2006 Conference, which was held in Cape Town, South Africa, concluded on Wednesday with "impassioned appeals to political and pharmaceutical industry leaders" to fund microbicide research, the AP/Seattle Post-Intelligencer reports (Nullis, AP/Seattle Post-Intelligencer, 4/26). The aim of the conference was to review progress in producing microbicides, which have been in development for 15 years. Microbicides include a range of products -- such as gels, films and sponges -- that could help prevent the sexual transmission of HIV and other sexually transmitted infections (Kaiser Daily HIV/AIDS Report, 4/26). It is hoped microbicides will enable "women to protect themselves without having to rely on partners who refuse to wear a condoms or be faithful," the AP/Seattle Post-Intelligencer reports (AP/Seattle Post-Intelligencer, 4/26). Coverage of some of the research presented at the conference appears below:
- The "race" to develop an effective microbicide has sparked a "turf war for human subjects," as the number of clinical trials have increased 16 fold in developing regions of the world, Ames Dhai, head of bioethics at the University of the Witwatersrand Medical School, told scientists on Wednesday, the Independent Online reports. About 10,000 women, mostly in Africa, are enrolled in microbicide clinical trials, and dangerous products often are used, according to the Independent Online. Dhai also said that trials might not always take into account the rights of participants, adding, "[I]nternational standards of ethics have starkly failed to deal with local contexts" (Independent Online, 4/26).
- Although an effective microbicide could be available in six years, it would take longer for it to be available in developing countries, Saul Johnson, executive director of health consulting company Health and Development Africa, told delegates on Tuesday, IRIN News/Independent Online reports. According to a study commissioned by the International Partnership for Microbicides, HDA finds that registering microbicides with South Africa's regulatory body, the Medicines Control Council, could be a long process, adding, "Even 'fast track' registration can take up to a year, and it's still unclear what products can be fast tracked." In addition, procurement, training and distribution of the products could further delay access to microbicides. Johnson proposed that regulatory agencies streamline their processes while microbicides still are in development (IRIN News/Independent Online, 4/26).
- South Africa's Department of Health is preparing for a time when microbicides are available, Deputy Health Minister Nozizwe Madlala-Routledge said Tuesday at the conference, according to the SAPA/Independent Online. Madlala-Routledge said the department was working with research institutes on microbicides and had sent a delegation to the conference, adding, "Our participation and our support for this conference should indicate our very strong support for this and also our own efforts at preparing ourselves for the time when this can be launched and used widely." She said that microbicides should not be seen as the only method of HIV prevention and urged dialogue on gender equality (Maclennan, SAPA/Independent Online, 4/26).
- Women living in developing countries would be less likely to disclose their HIV status if they test positive for the virus than women living in industrialized countries would be, according to a World Health Organization survey presented at the conference, Xinhuanet reports (Xinhuanet, 4/25). Lori Heise of the Global Campaign for Microbicides and colleagues surveyed 24,000 women in 11 countries -- Bangladesh, Brazil, Ethiopia, Japan, Namibia, New Zealand, Peru, Samoa, Serbia, Tanzania and Thailand, South Africa's Herald reports. The survey finds 52% of women in developing countries would tell their partner if they contracted HIV, while 71% of women in industrialized countries would do so. "Actual rates of violence when women disclose [their HIV-positive status] are relatively rare," Heise said, adding, "Women beaten upon disclosure are most likely to be in an existing violent relationship" (Herald, 4/26).
- Although condoms are likely to remain the most reliable tool for preventing the sexual transmission of HIV, microbicides can help empower women in developing countries to speak with their partners about sex and shared responsibility, Melissa May, spokesperson for the Population Council, said on Wednesday at the conference, VOA News reports. May said that "as long as there is expanded dialogue and men and women can talk about sex openly," microbicides and condoms will be useful when used together to prevent the spread of HIV. According to May, microbicides are "not going to be the silver bullet, the magic bullet," but they could be "another very important prevention tool" in the fight against HIV/AIDS, and as a "women-initiated product," microbicides "will help women prevent their own HIV infection" (De Capua, VOA News, 4/26).
- The ease with which women use microbicides might depend on how they are marketed, Sara Whitehead, a medical epidemiologist working on a CDC- and Thai government-run program, said on Wednesday at the conference, the South African Press Association reports. While microbicides usually are thought of as a women's prevention method, the decision to use them might not be controlled solely by women, she said, adding that recent studies show that women do not want to use microbicides without their partners' knowledge. Whitehead also said that marketing the microbicide gel as a lubricant could help a woman negotiate its use more effectively than if she said the gel was for "disease protection." She added, "Men may certainly be aware of what the product is supposed to do, and that it has an HIV prevention effect, but I think it makes the discussion, negotiation and decision making process much less awkward in some relationships if there are multiple purposes for the gel and you don't have to say which of the purposes is your main reason for wanting to use it" (South African Press Association, 4/26).
Kaisernetwork.org will webcast select sections of the conference.