For the first time in the grim history of the AIDS epidemic in Africa, scientists have identified two methods of action that can reduce the impact of HIV on women: an infection-blocking vaginal gel and financial aid that delays the onset of sexual activity. According to experts, both of these elements offer a chance for progress in the fight against a disease that has already killed millions of people.
Both methods were announced this week at the international AIDS conference in Vienna. This discovery is particularly important as the epidemic today mainly affects women. Men rarely use condoms or other methods to prevent transmission of the virus, and wives and partners are often too helpless to convince them to do so. In addition, poverty in large African families often forces girls and young women to engage in sexual activity prematurely.
A more important finding concerns the effectiveness of a vaginal gel that contains an antiretroviral agent. If women had direct access to it, this gel could help prevent their HIV infection. Unlike a condom, female partners would not have to agree to use it, they would not even need to know that it is in use at all. Clinical studies of the gel have shown that regular use can block more than half of new infections.
In another study, researchers found that the timing of the sexual activity of girls and young women can only be delayed by subsidizing their families with moderate amounts of up to a few dollars a month. Such a delayed moment of sexual initiation is associated with up to a 60% reduction in HIV infection.
This money appears to allow families more financial freedom while delaying the sexual activity of girls. And this, in turn, could positively affect their overall health, as scientists are counting on.
However, scientists are particularly pleased with the results of antiretroviral research, as more than 30 previous clinical trials of similar substances have not produced satisfactory results. “This is the first time such a drug has tested positive,” reports Anthony Fauci, director of the US National Institute of Allergy and Infectious Diseases. ‘Given that women are the majority of people living with HIV in the world, this discovery is an important step towards equipping this risk group with a safe and effective tool for preventing infection. (…)
It is estimated that 33 million people worldwide live with HIV, two-thirds of whom live in sub-Saharan Africa. Another 32 million died from AIDS-related health complications.
Previous efforts to develop a killer for pathogenic microorganisms have used detergents or other chemicals which, however, have not had any particular effect on the virus that causes AIDS. The new tests used the antiretroviral drug tenofovir, manufactured by Gilead Sciences in Foster City, California, which affects the replication process of the virus.
Clinical trials of the agent (using its XNUMX% solution in a colorless, odorless gel in a plastic dispenser) were organized by the research couple Dr. Quarraisha Abdool Karim and Dr. Salim S. Abdool Karim of the Center for the AIDS Program of Research in Durban, South Africa.
The study involved 889 sexually active women aged 18 to 40 who lived in KwaZulu-Natal, South Africa. About half of them were given a gel with an antiretroviral drug, the rest – a placebo. The women were told to use the gel within 12 hours before and 12 hours after the expected intercourse. Scientists later assembled the dispensers to assess whether their directions were followed.
Abdool Karims said on Monday on the Science website and at an AIDS conference that the measure reduced new HIV infections by 39 percent and new genital herpes infections (which affect HIV transmission) by about half.
In women who used the drug gel in at least 80 percent of the recommended cases, the number of infections was reduced by 54 percent. Among the subjects who used the gel with less than half of sexual contacts, the incidence of infections was reduced by 28 percent. The only noticeable side effect of using the drug (only in some women) was mild diarrhea.
Now scientists are looking for methods that would allow more accurate adherence to the drug application regimen. They are also testing different doses of its active ingredient to improve its effectiveness. Other AIDS experts have warned that before there is more hope in people, the results need to be repeated, as subsequent studies may not be as successful.
Fauci and other scientists believe the gel should be more effective, at least 80 percent, to be approved by the US Food and Drug Administration (FDA). But even then, it will be a few more years before it appears in pharmacies. (…)
The second study, funded by the World Bank, included around 3,8 Malawi women and girls aged 13-22. For participation in the program, the families of half of these girls received from $ 4 to $ 10 a month, and each of the respondents received from $ 1 to $ 5 each month. The other half was not paid.
After a year and a half, 1,2 percent of the girls who were paid were HIV-positive. Its presence was also found in 3 percent of the respondents from the group “without funding” – the researchers calculated.
This research “demonstrates the potential of small financial aid to keep people, especially women and girls, from engaging in risky sex while ensuring that girls stay at school to enjoy the benefits of education,” said David Wilson of the World Bank, responsible for HIV / AIDS program.
Thomas H. Maugh II, Los Angeles Times, 19.07.2010