As the HIV/AIDS epidemic increasingly impacts women worldwide, clinical trials of microbicides to prevent the sexual transmission of HIV will include women, and a product could be on the market in five years, Dr. Zeda Rosenberg, CEO of the not-for-profit International Partnership for Microbicides, said on Wednesday at the XV International AIDS Conference, Reuters reports. HIV/AIDS experts believe that a "partially effective" microbicide could prevent 2.5 million HIV infections over three years, according to Reuters (Reaney, Reuters, 7/14). Microbicides include a range of products such as gels, films, sponges and other products that could help prevent the sexual transmission of HIV and other sexually transmitted diseases. Although HIV is transmitted primarily through heterosexual intercourse in much of Africa and Asia, no female-controlled HIV prevention method currently is widely available (Kaiser Daily HIV/AIDS Report, 3/24). In addition, approximately 48% of adults living with HIV/AIDS worldwide are women, and 57% of people living with HIV/AIDS in sub-Saharan Africa are women, according to a report released on Wednesday by UNAIDS, the United Nations Development Fund for Women and the United Nations Population Fund, according to a UNAIDS release. The report, titled "Women and HIV/AIDS: Confronting the Crisis," said that women ages 15-24 in sub-Saharan Africa are three times more likely to be infected with HIV than men of similar age. In addition, women in sub-Saharan Africa also know less about HIV/AIDS than men and women's knowledge about the disease is often "rendered useless" by discrimination and violence against women (UNAIDS release [1], 7/14). An effective microbicide would be important for women in resource-poor countries whose husbands refuse to use condoms, according to the New York Times (Altman, New York Times, 7/14). An effective microbicide also could help protect men who have sex with men against HIV infection, according to a UNAIDS release (UNAIDS release [2], 7/14).

Microbicide Tests Underway
Several microbicides are undergoing clinical trials that by the end of 2004 will involve more than 28,000 women in the United States, Africa and Asia, according to the Times (New York Times, 7/14). An effective microbicide would kill HIV in semen, block the virus from attaching to a target cell or prevent HIV from multiplying if the virus enters a target cell, according to Reuters (Reuters, 7/14). Two microbicides -- one called Savvy, which is made by Biosyn, and another called Carraguard, which was developed by the Population Council -- are currently undergoing efficacy testing in Ghana and South Africa respectively, according to the Times (New York Times, 7/14). Four additional microbicides also will begin testing soon, according to Reuters (Reuters, 7/14). Rosenberg said that developing an effective microbicide is especially important because an effective HIV vaccine could be many years away, according to the Associated Press. She said, "When you can have a partially protective vaccine in 15 years or a partially protective microbicide in five years, it makes a whole lot of sense now to focus on microbicides" (Ross, Associated Press, 7/14). Rosenberg also said that although microbicides "will not be magic bullets" and "probably will never be as effective as condoms, ... even a partially effective microbicide could save millions of lives" (New York Times, 7/14).

House Appropriations Subcommittee Commits $30M for Microbicide Research
The House Appropriations Subcommittee on Foreign Operations has allocated $30 million in the USAID budget for microbicide research, which is an $8 million increase over the last fiscal year's funding level, according to an Alliance for Microbicide Development release. "Alarmingly, the face of AIDS has become increasingly female" -- with women accounting for more than 50% of people living with AIDS worldwide and 60% of those in Africa, Polly Harrison, director of AMD, said. She added, "Microbicides would give women everywhere power over AIDS in a way like never before by allowing them to protect themselves from the epidemic, even in societies where they lack the economic or societal standing to control their sexual encounters." Although AMD "applaud[s]" the increase in microbicide research funding, Harrison said, "[M]icrobicide funding is still woefully inadequate and greater leadership is needed" (AMD release, 7/13).

NPR's "Morning Edition" on Wednesday reported on the development of microbicides to help prevent the transmission of HIV for women who may not be able to negotiate condom use. The segment includes comments from International Center for Research on Women President Geeta Gupta; International Planned Parenthood Federation Director-General Steven Sindling; Sara Whitehead, head of microbicide research for a collaboration between CDC and Thailand; and a Ugandan HIV/AIDS advocate who advocated abstinence at the conference (Knox, "Morning Edition," NPR, 7/14). The complete segment is available online in RealPlayer.

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