No added HIV risk with hormonal contraceptives, one study finds: Results presented at Microbicides 2012
SYDNEY, April 17 – An HIV prevention trial that pre-dates the shift to antiretroviral (ARV)-based approaches is nonetheless helping to answer some of the most relevant and topical questions the field is facing today. More than three years after reporting the primary results of HPTN 035, one of the last trials of the so-called first generation microbicides, researchers from the National Institutes of Health-funded Microbicide Trials Network (MTN) reported two new sets of findings gleaned from the study’s trove of statistical data and laboratory specimens. The results of both analyses were presented at the International Microbicides Conference (M2012). The meeting, which started Sunday, April 15 and ends tomorrow, April 18, is being held in Sydney.
Are women who use hormonal contraception at greater risk of acquiring HIV? No, according to a retrospective analysis of HPTN 035 data reported earlier today, the latest round of conflicting information about an issue that has perplexed researchers and health advocates alike.
Are some women more biologically susceptible to HIV than others, and if so, is there a way to identify who they are? Yes, suggests the other study, a series of laboratory tests of vaginal fluid samples from former HPTN 035 participants, additionally pointing to a need for developing more targeted HIV prevention approaches for women who may be especially vulnerable.
Worldwide, an estimated 34 million people are living with HIV, more than two-thirds of whom live in sub-Saharan Africa. The number of new infections continues to outstrip advances in treatment: For every person starting HIV treatment, there are two new infections. In 2010, approximately 2.7 million people were newly infected with HIV– more than 7,000 every day.
Microbicides are products being developed to prevent or reduce the sexual transmission of HIV or other sexually transmitted infections (STIs) when used in the vagina or rectum. Vaginal microbicides are being designed in many forms, including gels, films or rings that release an active ingredient gradually over time. If proven effective, microbicides could help prevent HIV in women in developing countries where it most often is spread through unprotected heterosexual intercourse despite efforts to promote abstinence, monogamy and the use of condoms. Microbicides also could help prevent HIV in both men and women who practice anal sex. Unlike condoms, microbicides provide an HIV prevention strategy that is not controlled by one’s sexual partner. Different products at various stages in the development pipeline are being tested; with those that incorporate ARV drugs the furthest along in testing and the only products in clinical trials. Another promising ARV-based prevention approach is called oral pre-exposure prophylaxis, or PrEP, which involves the daily use of an ARV tablet more commonly used in the treatment of HIV by people who are uninfected.