While no magic bullet, a new antiretroviral gel developed in South Africa could help to significantly reduce the transmission rate of HIV between men and women
A TEAM OF South African scientists has released clinical trial results that show a new vaginal gel containing antiretroviral drugs offers women a strong level of protection against HIV infection during sexual intercourse.
The unveiling last week at the 18th International Aids Conference in Vienna of the positive results from a second phase of a three-stage trial has been hailed by policymakers and HIV activists as a landmark moment in the search for a way to reduce the transmission rate of the disease between men and women.
Young women in their early 20s in Africa have the highest HIV infection rate among the adult population, mostly because their male partners often refuse to wear a condom. This refusal by men to use contraception during sex has contributed to women accounting for about 60 per cent of new HIV infections in Sub-Saharan Africa.
It is hoped the development of the new gel will offer women a greater degree of control when it comes to protecting themselves against HIV infection.
According to experts, the newly developed prototype microbicide cream – a substance that reduces the infectivity of microbes – amounts to a significant breakthrough, as it has been proven to protect four out of 10 women who used it using strict guidelines.
“We are all very excited by the results,” Anthony Fauci, director of the US National Institute of Allergy and Infectious Diseases, told reporters at a press conference to announce the breakthrough. “This is the first time that there has been an unequivocally significant demonstration of the ability to block (HIV) acquisition in women by a microbicide.”
Director general of the World Health Organisation (WHO) Margaret Chan also hailed the gel, describing the findings from the research and trial, conducted in South Africa’s KwaZulu-Natal province by Prof Salim Abdool Karim and his wife Quarraisha, as “exciting”.
“We look forward to seeing these results confirmed. Once they have been shown to be safe and effective, the WHO will work with countries and partners to accelerate access to these products,” she said in a statement to the Vienna conference.
However, it was stressed at the conference that the gel should not be considered a “magic bullet”, but an additional weapon in the war to overcome the disease. Also the gel was not tested in instances of anal sex, which is said to facilitate a far higher HIV transmission rate than vaginal intercourse.
The medical trial involved testing the gel on 899 women from urban and rural South Africa who were HIV negative at the time the study began.
Half the women were given the gel while the other half were given a placebo. The women, who received HIV counselling and were advised to use condoms, were instructed to insert the gel inside their vagina 12 hours or less before having sex, and then again within 12 hours of the activity.
The results showed that using the gel reduced the risk of HIV infection by 39 per cent overall among women, but for those who used it most consistently the protection rate was 54 per cent. It was also found the gel cut the risk of a woman getting genital herpes by 51 per cent.
Prof Karim, head of the Centre for the Aids Programme of Research in South Africa which conducted the trial, said he and his wife were astounded to hear from a statistician who forecast how effective the gel could be in South Africa over the next 20 years. He revealed that if people used it in a similar way to how it was applied during the clinical trials then 1.3 million new infections and 800,000 deaths could be prevented.
“Of course we were hopeful, but when the statistician came in and gave us the results, we were absolutely stunned. We just looked at each other in disbelief and couldn’t speak for a while,” said Karim.
“This is the first prevention method designed specifically for women that has worked, and it is likely to electrify the HIV and Aids prevention field, which has had few successes in the past two decades.
“This has the potential to alter the course of the HIV epidemic, especially in southern Africa where young women bear the brunt of this devastating disease. We need to find a way of getting this into women’s hands as fast as possible.”
The South African government and US Agency for International Development donated the original funding to finance the gel’s development and carry out trials, with the former being given all rights to the microbicide by the Karims with a view to it being produced locally on a commercial basis.
The husband and wife team have now called for more funding to support their work so they can verify the recent results by carrying out the third and final stage of the trial, which is to take a number of years to complete.
