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Gel Is Next Hope for Preventing HIV in Women

Gels, Cream May Help Protect Highest Risk Group From AIDS Virus
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WebMD Health News

July 16, 2004 (Bangkok, Thailand) With development of a vaccine to prevent HIV infection still years away, AIDS specialists say that vaginal gels which kill HIV "represent a major breakthrough in the fight against AIDS."

Speaking at the XV International AIDS Conference, Zeda Rosenberg, MD, chief executive officer of the International Partnership for Microbicides, says that an effective gel to protect women could be available within five to 10 years. Such a gel, known as a microbicide, could prevent 2.5 million HIV infections over just three years, Rosenberg says.

"Even a 60% efficacious microbicide introduced into 73 low-income countries and used by only 20% of women would avert 2.5 million HIV infections during three years in women, men, and infants," she says.

While a vaccine against HIV is agreed to be the best way to prevent infection, experts are worried that none of the 30 or so candidates now being studied will actually be effective. A few have already failed to work in human studies. And all the remaining candidates are all based on the same strategy -- protecting against HIV infection by boosting one part of the immune system to fight off the tricky virus, says Wayne Koff, PhD, senior vice president and chief of vaccine research at the International AIDS Vaccine Initiative.

"Even though we have widened the pipeline, almost all the candidates are working on a single approach," Koff says. "They are so similar that if one fails, they all may fail."

The call for other prevention efforts, such as effective microbicides, comes at a time when almost half of the world's 38 million people living with HIV worldwide are women. And infection rates among women are growing much faster than those among men in many countries.

"Young women, especially those that are married, are being infected at astonishingly high rates, Rosenberg says. "Twenty-five percent of women in South Africa are infected by HIV by the time they are 22 years old."

In South Africa, adolescent girls who are five times more likely to become infected than teenage boys. Meanwhile, married women in sub-Saharan Africa are increasingly being infected by the virus because their husbands are unfaithful and will not use condoms, she says.

And it doesn't end there. Halfway across the world, in the Caribbean, nearly three-fourths of new HIV infections are now in women. "And unfortunately parts of Asia are not far behind," Rosenberg says. "So for women worldwide, being young and married are the most significant risk factors for acquiring HIV infection."

The bottom line: HIV-destroying microbicide gels and creams, used in combination with female condoms and diaphragms, must be a priority for prevention, Rosenberg says.

American actor Richard Gere tells WebMD that he agrees. "Yes, we all want to see an effective vaccine but that may be years away. In the meantime," he says, "a microbicide could serve as a way to prevent further transmission.

Microbicides can work in a number of ways: by killing or by preventing the virus from establishing an infection; by blocking infection by creating a barrier between the virus and the cells in the vagina that could become infected; or by preventing the infection from taking hold after it has entered the body, Rosenberg says.

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