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Could contribute an almost 30-year campaign against AIDS

Researchers may have found a HIV preventative gel, which contains an AIDS drug already on the market, that could decrease a woman's chances of getting HIV in half. It was announced at the International AIDS Conference in Vienna, but further testing is required to make sure the product is safe and effective. 

AIDS has claimed 25 million lives total, and 33 million more are infected by HIV. Of this total, two-thirds are from sub-Saharan Africa. In this area, 60 percent of new infections develop among women and young females. 

For years, the only way to prevent HIV infection was by the use of condoms and male circumcision, since the foreskin contains cells that are "vulnerable to penetration by HIV." But the latter only prevents HIV infection in males. 

The study was led by Quarraisha Abdool Karim and Salim Abdool Karim from the Centre for the AIDS Programme of Research in South Africa (CAPRISA) in Durban. It consisted of almost 900 South African women who were sexually active and between the ages of 18 and 40, where 444 received a placebo and 445 received the microbicide gel. It was conducted in both the urban setting of Durban and the rural setting of Pietermaritzburg in the KwaZulu-Natal province.

Over a three year period, these women were asked to apply the gel, which contains a mixture of antiretroviral drugs and a one percent formulation of tenofovir that interrupts the reproduction of HIV in immune cells, with a vaginal applicator within a 12 hour window before intercourse and within a 12 hour window after intercourse. They were then tested for HIV on a monthly basis. In comparison to the placebo group, those who used the microbicide reduced the risk of HIV by 39 percent overall. For those who used the microbicide more often, as directed, 54 percent of the risk of HIV was reduced. 

"Without this gel, we may see 10 women becoming infected in a year," said Salim Abdool Karim. "With this gel, we would see only six women becoming infected."

While no major side effects were observed over the course of the study, the gel did become less effective after 18 months of use, and researchers are looking into finding out why. Right now, they believe it may be due to the fact that 40 percent of the women "used the microbicide less than one time out of two." Also, they will continue testing the gel to make sure there are no long term side effects that will exist beyond a three year period. 

The study has been published in the journal Science and could prove to be a vital part of finding efficient, preventative ways to avoid HIV infection everywhere.

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Meekly points out....
By Amiga500 on 7/21/2010 2:37:12 AM , Rating: 2
That if the male was wearing a condom, the woman would be at a much lower risk of getting infected...

So what has changed? Are people that are struggling to put food on the table going to go out and buy this gel? (the same* people do not go out and buy condoms, which are probably cheaper too)

*obviously not the exact same, but the partner in the relationship.

RE: Meekly points out....
By martinrichards23 on 7/21/2010 4:29:25 AM , Rating: 2
1) Not everyone in Africa is "struggling to put food on the table".

2) The gel will most likely be given out free by charities and NGOs, assuming it is going to be used. So they won't have to pay for it anyway.

RE: Meekly points out....
By Amiga500 on 7/21/2010 5:07:46 AM , Rating: 3
1) Many of those with AIDS issues are.

2) Am I right in saying only a condom burst will allow AIDS to transmit? The odds of which are what? 1 in 100 approx? So a condom would reduce the chances of infection by...9900%? Compared to the 100% reduction of this gel.

I'm not against the gel - no doubt future developments will improve its effectiveness and hopefully reduce its cost. I just don't see how it is a better option in either cost or effectiveness compared to what is currently available. Thus I don't see how it is going to make a significant impact... at least until the necessary improvements come along.

RE: Meekly points out....
By abscode on 7/21/2010 5:12:14 AM , Rating: 4
It give the prevention power to the other party. That's why it's important and that's how it can have an impact.

RE: Meekly points out....
By zodiacfml on 7/21/2010 6:23:08 AM , Rating: 2
he is right. Some guys refuse to use one when being asked by the woman.

RE: Meekly points out....
By Amiga500 on 7/21/2010 8:06:50 AM , Rating: 2
Well, if the fella doesn't respect the woman enough to adhere to her wishes for something like this....

The choice of what she should do is pretty clear.

RE: Meekly points out....
By clovell on 7/21/2010 11:29:59 AM , Rating: 4
Should? This is Africa, after all. 'Should' is hard to find in the lexicon. The highest rate of rape of any civilized country is in South Africa. The Janjaweed use rape as a method of terrorizing Sudanese civilians (although since the cease-fire was declared between the Khartoum gov't. and two of the main rebel factions earlier this year, this may be less widespread).

I'm not blasting you - I just want to point out clearly that women in Africa do not enjoy the same level of protection as most of us are used to seeing. It's barbaric and unjust.

RE: Meekly points out....
By Denithor on 7/22/2010 10:18:01 AM , Rating: 2
Exactly. In many cases the woman has no means of defending herself against HIV, this potentially gives her a tool to do so that the man does not have to agree to use.

Influencing bad behavior?
By DoeBoy on 7/20/2010 7:51:30 PM , Rating: 2
This is a great thing to have and is another tool in the fight against aids. I do wonder if this will contribute to bad behavior in areas with seriously endemic aids. How about they learn to wrap it up like the rest of us do. Seems to be just delaying the inevitable because you know they wont wrap it up.

RE: Influencing bad behavior?
By abscode on 7/20/2010 9:28:23 PM , Rating: 5
Yea, because every tribal community and village has a Kwik-E-Mart with a condom machine in the bathroom.

You also need to restrain from putting western sensibilities in the situation; in many communities the women do not have the right to say no to their husband's advances. So if their husband gets some strange on the side and becomes infected, she has zero ability to defend herself from the same fate. This gel can help change that.

RE: Influencing bad behavior?
By ZachDontScare on 7/21/2010 2:44:44 PM , Rating: 2
Basic health knowlege is not 'western sensibilities'. Condoms prevent HIV very well. This gel only resists it. That is not a sensibility, that is fact. If the Africans want to continue to commit mass suicide by ignoring this, then maybe we ought to stop thinking about imposing 'western sensibilities', and start telling them to stop letting their 'african sensibilities' destroy their continent.

I do think this is a gread advancement, but I agree with some of the other posters - this may backfire and discourage condom use.

RE: Influencing bad behavior?
By abscode on 7/21/2010 3:54:39 PM , Rating: 2
That paragraph does not mention condon use; read it again. Hint: rape. You're arguing that rapers should all be good people and wear condoms when asked. You know that's not going to happen right?

RE: Influencing bad behavior?
By PrinceGaz on 7/22/2010 7:31:21 AM , Rating: 1
Yea, because every tribal community and village has a Kwik-E-Mart with a condom machine in the bathroom.

You clearleh have never visited those sort of communities otherwise you would know that is most definitely not the case.

Horrible idea
By danobrega on 7/21/2010 5:34:33 AM , Rating: 4
Giving something to people that makes them feel safe about having risk behavior when in fact they are still in danger is a terrible idea. It could easily back fire, you reduce the chance to get infected but increase the number of people that are exposed.

Would you use a "half as bad" parachute? I wouldn't.

RE: Horrible idea
By clovell on 7/21/2010 11:31:44 AM , Rating: 2
If people are going to jump out of a plane anyway, then yeah - I say we give it to them. Unfortunately, your pipedream logic is being applied to reality here.

RE: Horrible idea
By xthetenth on 7/21/2010 11:35:52 PM , Rating: 2
You make it sound as if it's a matter of choice that they get exposed to aids. Between rape and the deplorable state of women's rights in africa, they don't in huge numbers. And put bluntly, the men 99% of the time don't care if the woman gets infected. The woman cares if she gets infected and now she has the ability to reduce the risk if that comes to that. It's a good step.

Glad to See this Made it to DT
By clovell on 7/21/2010 11:40:20 AM , Rating: 3
First of all, thanks for taking the time to write this up, Tiffany. The study was definitely a proof of concept, but it's particularly cool to see that Gilead was able to make tenofovir bioavailable in a gel form.

Anti-retrovirals (ARVs) used to fight HIV have a long history of being finicky when it comes to stability. Especially in terms of formulation or heat resistance.

I do take particular issue with the study when it claims that the gel does not confer viral resistance. Viral resistance for this class of drugs (Protease Inhibitors) is generally determined by genotyping the virus and seeing if mutations occur during the course of treatment, which are known to confer resistance.

Now, this is usually tested on at least a thousand infected subjects. Since this was an anti-infective trial, with <900 patients, and <10% infection rate, we really only have 100 patients to check for resistance on. However, it's good to see that they found no evidence of the gel conferring resistance.

In any event, it will be interesting to see where this goes. Tenofovir's mechanism of action is to prevent the virus from replicating. It doesn't kill HIV. It stops the virus protease from cleaving the virus (mitosis), and eventually the virus recedes. I'm interested to understand how it works here.

By CowKing on 7/21/2010 4:23:34 PM , Rating: 2
You guys ever think that this sex might not be consensual and that's why guys aren't wearing condoms? just saying. Rape is a pretty big problem in Africa; mostly the sub-Sahara region

Irresponsible journalism
By oTAL on 7/22/2010 4:20:41 AM , Rating: 2
For years, the only way to prevent HIV infection was by the use of condoms and male circumcision, since the foreskin contains cells that are "vulnerable to penetration by HIV."

Providing false information is bad enough... but providing false information that may lead people to a false sense of security towards something like HIV is downright irresponsible.

Whether you know it or not you just equated circumcision to a condom (at least from a male point of view). Are you out of your mind??

There have been some studies that appear to show a somewhat significant reduction in infection rates on circumcised men. However, this should NOT be used as a prevention method. No one sane would even suggest that.

I'm not one to make a big issue out of small things but I do thing such an absurd statement on such an important matter really needs a correction and an apology to your readers.

DT desperately needs to be more careful on what it presents as fact. If your readers loose trust, you loose the readers...

By Phoque on 7/20/10, Rating: -1
RE: circumcision
By sprockkets on 7/20/2010 9:16:48 PM , Rating: 2
I'm also happy for those future men that may not be butchered because their parents feel it may not be as important since the advent of better alternatives.

Butchered? Do you know what circumcision is?

RE: circumcision
By AssBall on 7/20/2010 10:12:58 PM , Rating: 4
Apparently you have strong feelings against improving upon what nature gives us. You're welcome to keep your appendix, tonsils, and foreskin. The problem I have is when people like you begin handing severe judgements down on anyone who doesn't follow your faith driven doctrine.

RE: circumcision
By Phoque on 7/21/2010 7:03:36 AM , Rating: 2
I respect people who make such decisions of their own. I'm just not comfortable with parents deciding for their kids about circumcision.

Telle me, how many of those who are circumsized when they are babies do you think would do it when they are an adult?

I wouldn't mind parting with my appendix and tonsils.

The problem I have is when people like you begin handing severe judgements down on anyone who doesn't follow your faith driven doctrine.

I assure you, it's only an opinion, a matter of feeling. I am strongly against following blindly doctrines and dogmas.

RE: circumcision
By medys on 7/21/2010 7:41:44 AM , Rating: 1
What do you care if somebody cuts piece of skin from your penis and you do not even remember it?

Also Circumcision is best done as early as possible because later either your parents have very high persuasion skills or you are scared of it, maybe even traumatized. If you do it even later it is even worse... Believe me its not funny if you get an erection and your schlange is not healed yet....

Talking about the drug :-/ I do not think 40% is good enough in such case. However prostitutes might find use for it.. Extra 40% will not hurt.

RE: circumcision
By tastyratz on 7/21/2010 8:39:11 AM , Rating: 3

on circumcision: This is a hot button topic right now. Some believe its butchering and not allowing a child to make a decision, others believe its standard. It can also have religion based reasoning.
Depending on what country you are in circumcision can be the predominant choice

I present this however: Having the "weird penis" in the locker room could do some serious emotional damage to a young teen, just as grossing out your girlfriend, etc.
I will choose circumcision for this reason, I don't want my personal belief causing such an intimate part of my sons body when the time comes to be anything that makes him stand out in a negative respect, and I respect your choice also. If when the time comes to make the choice popularity drops like a rock and circumcised becomes the minority, I will choose not to.

No male will choose to chop their penis without severe trauma beforehand at an age old enough to decide. Whatever they have will be "normal to them".

with the gel: 40% is definitely useful enough because its 40% more than we have now. After thorough testing government mandate could force all lubricant manufacturers to include it in their formulas.
Maybe somday they will have more than 40%, but right now that's what we have and I will take it over 0%

RE: circumcision
By sprockkets on 7/21/2010 10:57:22 AM , Rating: 2
i bet if he knew what a sharp blade he would have for the ladies meant no guy would say no

RE: circumcision
By Phoque on 7/21/2010 4:16:01 PM , Rating: 2
I present this however: Having the "weird penis" in the locker room could do some serious emotional damage to a young teen, just as grossing out your girlfriend, etc.

I get your point, but then you become a fashion victim. Each time the fashion changes, you have to adapt not to be the black sheep people will laugh at. I hope this is only one of the rare exception where people do that ( follow the crowd ), but I'm affraid not.

Also, kids which have had tough experiences while they were young, but were still well surrounded and supported socially, tend to be happier and stronger emotionnally than those who had it easy.

RE: circumcision
By tastyratz on 7/21/2010 9:07:58 PM , Rating: 2
getting life handed to you vs getting through a tough life for the better are very different. We aren't talking about a lisp when they were younger, we are talking about a whole different... "ball" game.
There are some times you want to make a fashion statement of individuality, but there are others where you don't. If my child were born with a miniature arm growing out of his forehead I would want it removed to be a fashion victim like the rest instead of teaching him how to triple flip people off.

You might as well be the kid with the forehead arm. When I was in high school my female friends made such sounds of disgust at the suggestion. I was glad as hell I wasn't uncircumcised.

RE: circumcision
By tygrus on 7/22/2010 5:41:03 AM , Rating: 2
50% effective over 12months. How many times were they exposed to HIV ? If exposed 5 out of 20 then it stopped 90% of potential infections. It still gives a wide window of potential infection. There may be a small difference between getting HIV this year compared to a year or two later. It's still may be useful to delay the spread, reduce the infection rate, reduce the number of births to affected parents and children to live longer before HIV affects parents.

The ineffectiveness over time may be because compliance rate drops as people become complacent. The immune system may react to the cream after many users and reduce it's effectiveness.

RE: circumcision
By acase on 7/21/2010 12:44:14 PM , Rating: 1
I am circumsized and I will probably have my son circumsized if I ever have one. However, I wish I could remember what they said, but I did see an episode of Penn and Teller's Bullshit where they brought up some really interesting and almost persuasive reasons against it. Obviously it wasn't persuasive enough though...

RE: circumcision
By chick0n on 7/20/2010 11:51:55 PM , Rating: 1
wow, how stupid a person can be. look at this Phoque guy.

RE: circumcision
By Phoque on 7/21/2010 7:28:33 AM , Rating: 1
For similar reasons, I love you too.

<something stupid for you>
With non circumsized love,
</something stupid for you>


RE: circumcision
By DaveSylvia on 7/21/10, Rating: 0
RE: circumcision
By Phoque on 7/21/2010 4:36:06 PM , Rating: 2
I apologize, the word butchered was indeed misplaced.

It just says, in a poor manner, indeed how I feel about the practice.

Again, I am just shocked at parents making such a decision for their sons (*).

I wish every men made that decision for themselves when they are no longer under their parent's authority, or at a time they have their word to say, so that it actually means something to them. I see circumcision more as a rituals of passage (*).

(*): When there are no rampant health issues such as HIV.

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