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    Prevention Now Central to AIDS Fight

    International Focus Is on Ways to Prevent New HIV Infections

    HIV in Women continued...

    Even if it's not 100% effective in humans, a little benefit can go a long way, she says. One recent study suggests a microbicide that lowers the risk of infection by 40% -- and is used by 30% of at-risk women in developing nations -- could prevent more than 2 million infections a year.

    The first-generation microbicides furthest along in development have to be used right before sex. But researchers are already developing second-generation microbicides, using more potent antiviral drugs, that could be taken hours, even days, in advance.

    AIDS Prevention Pill

    Other researchers are studying vaginal rings that gradually release antiviral drugs, similar to those used to deliver contraceptives. In early testing, the ring proved safe and consistently dispensed the drug for seven days.

    Another method that could be available even sooner is an AIDS prevention pill. Testing on about 860 high-risk women in Cameroon, Ghana, and Nigeria suggest the approach is safe and feasible, researchers report.

    While the numbers were too small to prove effectiveness, "the data are encouraging enough to propel us ahead," says Robert M. Grant, MD, an AIDS specialist at the University of California, San Francisco, who was not involved in the research.

    Circumcision Circumcision , too, could soon join the arsenal of HIV preventive methods. New research suggests the centuries-old practice could avert hundreds of thousands of new HIV infections and save millions of dollars.

    Novel HIV Therapies

    For people already living with HIV, potent drug therapies can now suppress the virus to barely discernible levels -- even if the person has failed other regimens, according to new guidelines for HIV treatment.

    But not all people can take all drugs. That's why novel compounds in the pipeline are generating so much enthusiasm.

    Among them is the experimental agent MK-0518, one of a new generation of drugs that blocks integrase. That's an enzyme HIV uses to integrate its genetic material into the DNA of human cells. It works differently than any of the antiviral drugs currently on the market.

    While MK-0518 targets HIV after it has already infected cells, two other experimental agents stop the virus from ever getting through that door.

    Those compounds, which block two key cell entryways, can knock back HIV in people with a long history of antiviral therapy, researchers say.

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