January 26, 2011
Thirty years into the HIV/AIDS epidemic, and after decades of research disappointments, 2010 brought major breakthroughs that put scientific advances such as microbicides, pre-exposure prophylaxis (PrEP) and vaccines within reach and created a favorable environment for other prevention and treatment efforts. Some experts predict that some of these discoveries will change the trajectory of the AIDS epidemic.
In part 1 of this two-part series, we examined the top five of 10 major stories of 2010 and how experts expect them to unfold during 2011. Here, we look at numbers 6 through 10:
Could applying a gel to the vagina or rectum one day prevent HIV? Scientists hope so. Last year, South African researchers reported breakthroughs in microbicide research. They found that inserting a vaginal-gel version of the antiretroviral medicine tenofovir (prescribed in pill form as Viread) could reduce HIV incidence in women by 39 percent -- and up to 54 percent in the most careful users.
What to watch: Never have scientists been closer to identifying a viable microbicide than they are today. Next steps include confirming these results. Some experts believe that a microbicide for women could be on the market by 2014. Efforts to develop a rectal microbicide are also under way; however, vaginal and rectal tissue are very different from each other, so this research may take significantly longer.
U.S. government scientists discovered new AIDS antibodies last year, one of which neutralizes 91 percent of known HIV strains. This remarkable discovery was found in a 60-year-old African American gay man (aka "Donor 45"), making him the world's secret weapon in the race to create a vaccine.
What to watch: Donor 45's body produces these potent antibodies naturally. The next steps include replicating this work in a living being rather than just in the lab. Yet this and other discoveries have created momentum (pdf) and excitement in vaccine research.
Forget about that apple. Someday a pill a day may help keep the HIV away from those at high risk for contracting the virus. Late last year, scientists proved that a daily dose of the oral antiretroviral drugs tenofovir and emtricitabine (brand name Truvada), used as pre-exposure prophylaxis (PrEP) (pdf), help prevent HIV transmission among men who have sex with men by 44 percent on average -- as high as 73 percent for those who protected themselves most consistently. So instead of having to negotiate with a (perhaps unwilling) partner about wearing a condom, with PrEP you would have the ability to protect your own body independently -- without your partner even knowing it.
What to watch: The study ends in March of this year. Even then, additional research must be done before oral PrEP hits your local pharmacy's shelves. About 20,000 people are participating in PrEP trials around the world.
Social media provide the latest tools to take the AIDS movement to the streets, as programs like Greater Than AIDS and GMHC's New York "I Love My Boo" campaign have helped spread messages designed to increase preventive activities and reduce stigma, for instance.
What to watch: This year, HIV/AIDS social media campaigns will target Black gay men, Black women and faith leaders, among others.
Does a cure for HIV really exist? That's what many media reported when German researchers who had performed a stem-cell transplant on Timothy Ray Brown, an HIV-positive man with leukemia (often called "the Berlin Patient") claimed to have destroyed his HIV cells. Brown's virus has been suppressed, making it undetectable; however, doctors can't guarantee that it has been eradicated. Furthermore, the procedure is both expensive and dangerous -- you have to be very sick to receive it -- and only 1 percent of White people in Northern and Western Europe carry the genetic variety of stem cells needed for this procedure. Still, the findings do point to another possible trail: Can genetically modified stem cells destroy HIV cells? If so, might this one day become a viable treatment?
What to watch: Don't hold your breath, take off that condom or expect media organizations to admit that they overhyped the story. Researchers remain early in the process of engineering stem cells that might "cure" the virus.
Ramon Johnson is the gay-life guide at About.com, part of the New York Times Company.