Thursday, July 29, 2010

Microbicides and HIV

This post is not really about Peace Corps or my application, but it's about some pretty exciting news to me...


There are several studies underway right now that explore microbicides as a way of preventing HIV infection. One study involves a silicone ring containing an antiretroviral drug- Dapivirine ( http://seattletimes.nwsource.com/html/nationworld/2012268199_africahiv04.html ). Another study that just announced preliminary results at the International AIDS Conference in Vienna last week involves a topical gel containing the antiretroviral drug Tenofovir. Researchers found that the gel reduced HIV infection by 50% (after a year) and it reduced the risk of genital herpes by 51%. The results have not been published in a peer reviewed journal yet, but the study methodology seems sound to me from what I've read so far (large sample size, double blind and randomized controls). See article here: http://www.cnn.com/2010/HEALTH/07/19/hiv.gel.protection/index.html?hpt=T2

Heterosexual intercourse is by far the main mode of HIV transmission in the world, with women at a greater risk than men due to biological and sociological reasons. Biologically women are more susceptible to HIV infection than men. The female genital tract has a greater mucosal surface area than the male genital tract, thus allowing for a greater risk of infection with every exposure. Younger women may also be more biologically vulnerable to infection due to less mature tissue. Gender norms related to masculinity may encourage men to have multiple sexual partners and older men to have sexual relations with much younger women. Violence against women increases their vulnerability to HIV, as forced sex can cause tears and lacerations in the vaginal tract that increase risk of HIV transmission. Additionally, gender-related barriers in access to services can prevent women from learning their HIV status or accessing treatment. Women may face barriers due to their lack of access to and control over resources, child-care responsibilities and limited decision-making power.


Many women do not have the social or economic power necessary to insist on condom use and fidelity, or to abandon partnerships that put them at risk. This area of research is so exciting to me because microbicides would not require a partner's cooperation, they would put the power to protect into women's hands.

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