With the lack of an AIDS vaccine, research continues to develop easy to use topical medications to prevent infection by HIV, the virus that causes AIDS, and other sexually transmitted diseases. This type of medication - possibly a gel, cream or suppository - is called a microbicide. Microbicide research was discussed at a recent scientific meeting here in Washington. Voice of America’s Cole Mallard spoke with three of the specialists from the meeting.
The Global Campaign for Microbicides says the product would be “the most important innovation in reproductive health since the birth control pill.” But no safe or effective microbicides are currently available.
Marge Chigwanda, a community educator in Zimbabwe for the HIV Prevention Trials Network, says it’s needed for women who have little or no say in having safe sex.
"Being a woman, I’m very hopeful for microbicides that I’m now given a choice, you know, in terms of protecting myself," she says.
The HIV Prevention Trials Network, or H-P-T-N, is funded by the U-S National Institutes of Health. It includes research organizations that promote community involvement in the effort to prevent HIV/AIDS.
Dr. Janet Frohlich is the international community chairperson for the H-P-T-N. Dr. Frohlich, who’s based in South Africa, says community participation in microbicide research is critical.
"Communities are living the epidemic, which maybe you and I aren’t. We might be affected [by] it at a different level. But when communities are living and experiencing a situation, it is a most natural response for one to be able to become part of a solution or problem to your own setting or your own community. And this is why we have such an overwhelming response of communities wanting to engage within the process, if they’re brought on board right at the initiation stage, and they’re consulted in the process," she says.
Dr. Frohlich says community involvement begins with specific steps. For example, in Africa, the first step is to engage the local leadership, then consult with N-G-Os -- such as faith-based organizations and women’s groups.
She says, "They would then be able to discuss the idea of microbicides – what is a microbicide, what does microbicide mean to women’s health within the whole notion of reproductive health, what does microbicide mean to involving men and how important it is that we are able to engage men into this process."
Dr. Frohlich says it’s important to keep the community informed on the progress of research projects – and provide what she calls a “recipe” for how the work will be done.
Awareness of the need for community involvement is relatively recent, says community educator Marge Chigwanda of Zimbabwe.
"Working with the community has been a new concept within H-P-T-N, and it has really been taken on well by the community in the sense that they’ve got a voice in what is happening," she says.
For example, Ms. Chigwanda says many HIV positive women are growing impatient with what they view as the slow pace of microbicide research. And Ms. Chigwanda says that impatience must be taken into account when asking the community to participate in clinical trials.
Meantime, a critical question remains – when will a safe, effective and affordable microbicide become available? Dr. Zvavahera Michael Chirenje, a Zimbabwean gynecologist and researcher for the HIV Prevention Trials Network, thinks it will happen in the next few years.
"The intense effort, which is underway now in the microbicide arena in various continents -- we’re targeting probably to have a product on the market by 2007," he says.
Public health experts say microbicides that are even 60 percent effective against HIV could prevent millions of HIV infections.
The Global Campaign for Microbicides says scientists are currently researching as many as 60 different products. But it says, “Investment in microbicide research and development must expand dramatically--and quickly--if the promise of microbicides is to be realized.”
