Achieving Consensus Around the Definition of a Microbicide

The field is finally moving toward consensus around the definition of a topical microbicide. In every presentation I attended during AIDS 2008 that provided a definition of a topical microbicide, they all stated the exact same definition and it included the word "rectal." It's about time!

I attend a HIV, STI, or microbicide conference nearly every quarter and this is the first time I have heard the definition articulated in a consistent way across presentations made by researchers from different organizations with different research agendas. Researchers from the Microbicide Trials Network (MTN), Center for the AIDS Programme of Research in South Africa (CAPRISA), and the International Partnership for Microbicides (IPM), for example, were all on the same page, finally, with regard to the definition of a topical microbicide. While these researchers and organizations may all have different strategies, plans, and foci for the development of a microbicide, it was great to finally see consistency and the word "rectal" included in the basic definition of the concept.

For the record, at least for the time being, let's use this basic definition when we describe the concept of a topical microbicide: a product that can be applied to the vaginal and rectal mucosa with the intention of preventing the transmission of sexually transmitted infections, including HIV.

And, as the field grows, this definition may evolve, as it has over the past year to include the word "rectal." Some researchers are already dropping the words "topical microbicide" and replacing them with the term "topical pre-exposure prophylaxis (PrEP)," which is a bit controversial to some, but fine by me, as long as what they describe continues to include both words "vaginal" and "rectal."

Congrats to the microbicide field for reaching consensus and to two individuals in particular -- Jim Pickett of International Rectal Microbicides Advocates (IRMA) and Dr. Ian McGowan -- who from my perspective have been instrumental in making this happen.