Anti-HIV Microbicide Could Soon Hit Market

At the American Foundation for AIDS Research meeting in San Francisco yesterday, researchers said topical treatments that prevent the transmission of HIV may be ready for market far sooner than a vaccine. "We think there may be a ready-for-use product on the market perhaps sooner than a vaccine, and right now, in this epidemic, we need to fight with all the tools we have," said Dr. Polly Harrison, director of the Alliance for Microbicide Development in Silver Spring, Md.

One product in human clinical trials enhances the vagina's natural defenses against HIV using an acid buffer compound. Another alternative is an absorption inhibitor, which is composed of sulfated and other charged polymers that block the absorption pathways of HIV on the genital surfaces. The most promising of these, Carraguard, is a seaweed-based gel in Phase 3 clinical trials. Researchers at Quebec's Laval University have been developing an "invisible condom" -- a non-toxic polymer-based liquid that solidifies into a gel at body temperature and protects against HIV transmission. Now in Phase 1 clinical trials on female patients, this product could be on the Canadian market as soon as next year.

While some researchers focus on creating microbicides, others are studying who will use the products. Existing prevention strategies -- mutual monogamy among HIV-negative partners and condom use -- are not options for many women, particularly where they lack the status to demand condom use. In contrast, a microbicide could be used without a woman's partner even being aware of it. A recent study by the Alan Guttmacher Institute indicated an estimated 21.3 million women in the United States alone would use the products. But another study, by the Institute for Community Research, concluded that additional support would be necessary for women to incorporate microbicides into their regular sexual practices.

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