As the HIV pandemic continues to claim lives of productive citizens here at home and across the globe, HIV researchers are not giving up and are working tirelessly conducting research in developing products such as microbicides which are being touted to hold key in future efforts to halt the spread of the virus.
According to the International Partnership for Microbicides (IPM), microbicides can be defined as products being developed to help prevent transmission of HIV to women during sex with a HIV-positive male partner.
Microbicides are based on the same types of antiretroviral (ARV) drugs used successfully to treat HIV-positive individuals and to prevent mother-to-child transmission of the virus.
Microbicide development has entered a promising chapter, with recent research showing that ARVs can be effective in preventing HIV.
A new vaginal ring called “The Dapivirine ring” pioneered by IPM is a vaginal microbicide made out of flexible silicone designed to provide sustained release of dapivirine to help protect against HIV infection. Women would replace the ring themselves every month.
Dapivirine is a potent ARV drug that belongs to the same class of ARVs already being used successfully to treat people with HIV and to prevent mother-to-child transmission. Seventeen IPM clinical studies have found dapivirine and the ring to be safe, acceptable and well-tolerated.
At present, there is no any microbicide on the market which can be readily utilised as researchers are still monitoring the safety, acceptability and tolerance of microbicides such as the new IPM’s vaginal ring.
“The HIV epidemic continues to disproportionately affect women in developing countries, yet they lack practical, self-initiated tools they can and are willing to use IPM’s monthly microbicide ring and other technologies in development could help empower women with discreet and long-acting tools they can use to protect their own health,” reads in part of an IPM factsheet.
In Malawi, Journalists Association Against Aids (JournAids) is working with IPM, University of North Carolina (UNC Project), AVAC and Southern Africa Aids Trust (SAT) to engage the local media, civil society, HIV researchers and relevant stakeholders to bridge the HIV research and knowledge gap.
Journ Aids has already trained a group of journalists in the central region and is also planning to roll out a country wide media capacity strengthening programme so that the media raises awareness and help in stimulating policy dialogue and debate to ensure that research around New HIV Prevention Technologies (NPTs) such as microbicides makes a real impact.
UNC Project Study Coordinator Tchangani Tembo is optimistic that effective media engagement is a good starting point to raise awareness on NPTs such as microbicides.
“ I think the media has an important role to play in raising awareness on microbicide research and other HIV prevention technologies, we need to sustain this type of work,” says Tembo.
He argues that many women do not have the social or economic power to insist on condom use. They require the consent of the male partner. Microbicides would not require a partner’s cooperation. Instead, they would put the power to protect into women’s hands.
In Malawi there are mainly two clinical trial sites that carry out microbicide studies: the University of North Carolina (UNC) Project situated at Kamuzu Central Hospital campus and the Johns Hopkins University (JHU) which is located within the premises of Queen Elizabeth Central Hospital.
The two sites mainly conduct research in vaginal microbicides and Pre-exposure prophylaxis studies for the prevention of sexual transmission of HIV amongst other studies.
Thomas Psyata is an editor with Galaxy FM Radio, a beneficiary from the IPM supported work through JournAids. He acknowledges the need to engage the media and raise awareness in microbicide research.
“We should bear in mind that women are highly affected by HIV more than men. Therefore it is important to invest in HIV research and microbicides as a promising HIV prevention option,” he says.
Another journalist, Owen Nyaka, a correspondent with AIDS SPAN and Citizens News Service (CNS) agrees with Psyata on the importance of promoting HIV research and raising awareness on microbicides.
“We need to increase scientific knowledge and awareness on microbicides as this is a new field. Microbicides are very critical as they will complement other already existing HIV prevention tools,” he says.
Maureen Luba, Dream programme manager and a fellow of AVAC, a global HIV advocacy organisation, points out the need for Malawi to increase investment in microbicides and HIV research as this is strategic in HIV prevention responses.
She adds that the country has not performed well in HIV research and stresses on the need to promote microbicides which if introduced on the market in a few years to come will play a crucial role in national HIV prevention efforts.
The new 2015-2020 National HIV Prevention Strategy estimates that Malawi has 1,000,000 People Living with HIV and Aids which includes 850,000 people aged 15 years and above and 170,000 children below 15 years of age.
The United Nations Joint Programme on HIV/Aids (UNAids) most recent estimates on the epidemic show a prevalence of HIV at 10.3 percent indicating a slight reduction in prevalence from 10.6 percent in 2010.
IPM is collaborating with global, regional and national partners to plan for the potential roll-out, availability and affordability of the dapivirine ring to women in developing countries.
It is also working with regulatory agencies in developing countries as well as the World Health Organization, the European Medicines Agency and the US Food and Drug Administration to prepare for dapivirine ring licensure.
The fact remains that HIV is a huge public health challenge, investing in HIV research and development of products such as microbicides is essential to save millions of lives and enhance sustainable development from now and the foreseeable future.
Microbicides
What they are?
Microbicides are compounds that can be applied inside the vagina or rectum to protect against sexually transmitted infections (STIs) including HIV. They can be formulated as gels, creams, films, or suppositories. Microbicides may or may not have spermicidal activity (contraceptive effect). At present, an effective microbicide is not available.
Why they are important?
It is important to support the development of microbicides because:
- Despite the knowledge of successful HIV prevention strategies – condom use, reduction in the number of sexual partners, diagnosis and treatment of sexually transmitted infections – HIV continues to spread at an alarming rate especially among women in developing countries;
- Without a preventive HIV vaccine, microbicides offer an alternative to condoms as the most feasible method for primary prevention of HIV.
- Currently available HIV prevention techniques are often not feasible for many women who live in resource poor settings. The availability of microbicides would greatly empower women to protect themselves and their partners. Unlike male or female condoms, microbicides are a potential preventive option that women can easily control and do not require the cooperation, consent or even knowledge of the partner.
How they work?
There are different ways in which microbicides act to prevent infection with genital pathogens. Some microbicides provide a physical barrier that keeps HIV and other pathogens from reaching the target cells.
Another class of microbicides acts by enhancing the natural vaginal defence mechanisms by maintaining an acidic pH, which protects the vagina.
Another class of products acts by preventing replication of the virus after it has entered the cell.
There are 23 microbicide products in various stages of clinical development.
Key conclusions from the technical consultation include:
Human resources, infrastructure and supplies needed
Distribution of microbicides will be influenced to a large extent by whether they are available for sale by prescription or over-the-counter (OTC). If an effective microbicide becomes available for use on the market as an OTC it can use the same distribution system as condoms. Their use can be advocated for in HIV/Aids STI, maternity and family planning clinics, and in youth or adolescent health care. Health care personnel working in this variety of settings can be trained in the use – and importance – of microbicides.
Leave a Reply