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April 18, 2008

Tests of HIV microbicides show promise, Pike says

Cleveland--Despite the failure to develop a vaccine to protect against HIV infection, there is hope for preventing the spread of the disease in the Third World and beyond: microbicides.

That was the message of an April 11 community briefing held by the AIDS Taskforce of Greater Cleveland at Cleveland Public Theater. The theater is currently producing In the Continuum, a day in the life of two women, one in Africa and one in Los Angeles, as both discover they have been infected with HIV.

Microbicides, currently being tested, are gels or creams that could be applied vaginally or rectally before sex to lower the risk of sexually transmitted infections.

AIDS Taskforce executive director Earl Pike noted that, while condoms are more effective than a microbicide would be, the use of condoms puts women’s health and safety in the hands of their male partners in areas of the world where women are often treated like chattel.

A microbicide, on the other hand, could be applied by the woman prior to sex, without needing any cooperation from her partner.

This would be a major prevention boon in places like sub-Saharan Africa, where 59 percent of people living with HIV are women, many of whom have only had sex with their husbands.

“Women need HIV prevention tools that they can control to safeguard their health and that of their families and communities,” reads a Global Campaign for Microbicides fact sheet on current research.

Microbicides could work in a number of ways, including attacking the virus itself, keeping it from getting into human cells, or stopping its spread once it got into the body.

The National Institutes of Health last year approved the Case Western Reserve University/University Hospitals AIDS Clinical Trials Unit as part of the Microbicide Trials Network. The University Hospitals ACTU joins 11 other centers around the world, five of them in the United States, in testing microbicides.

Pike noted during his presentation that a microbicide that was 60 percent effective, widely distributed, would mean two million fewer transmissions of HIV over a three-year period.

Microbicides will need to be tested separately for safety in vaginal and rectal uses. Ten different compounds are currently in the clinical trial stage, which will determine whether they are safe and effective for humans to use.

For example, nonoxynol9, a spermicide added to some lubricated condoms, was found in the 1980s to kill HIV. But further research revealed that it also irritates vaginal and rectal tissues, actually increasing the chance of HIV transmission.

Other speakers at the community briefing included Cleveland public health director Matt Carroll, anthropology professor Janet McGrath, community advocate Matifadza Hlatshwayo, Cleveland Public Theater executive artistic director Raymond Bobgan and AIDS Taskforce associate executive director Tracy Jones.

In addition to In the Continuum, Cleveland Public Theater is displaying “Giving Women Power Over AIDS,” an exhibit illustrating the terrible toll the disease is taking on women across the world. Much of the exhibit focuses on a woman named Ruth who died of AIDS in Zimbabwe, adapted from a 2003 Seattle Times photo essay.

The exhibit is alternately heart-rending and inspiring, illustrating the personal and global toll of AIDS while also looking forward to a day when the plague can be held in check.

For more information about In the Continuum, running through May 3 at Cleveland Public Theater, call 216-6312727 or go to www.cptonline.org.

Information about the microbicide trials at University Hospitals is available at www.clevelandactu.org.


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