Postcard From Delhi: The View From the Microbicide 2008 Conference

by Gus Cairns on AIDSmeds.com, posted March 18, 2008

The scientific troupes were restless at the biannual Microbicides 2008 Conference, held earlier this month in Delhi, India. Prevention experts from around the world had gathered there to discuss the latest developments in this important arena of HIV/AIDS prevention. Despite the international AIDS community’s high hopes for these gels or creams—possibly to be paired with a device such as a diaphragm or vaginal ring—incorporating an HIV-neutralizing substance to block sexual transmission of the virus, the development of a safe and efficacious microbicide continues to elude researchers.

Indeed, just prior to the conference, one massive study conducted among South African women concluded that the microbicide being studied—in that case, Carraguard—made no difference in HIV infection rates. And another recent study indicated that the microbicide in question may have actually increased the participants’ risk of infection rather than protecting them. Still, despite the frustrating news of late, indeed perhaps in response to it, there was little indication of any waning commitment to develop an effective microbicide.

HIV prevention advocates have been urging the development of such compounds since the early 1990s, when they started noting how much more vulnerable young women were to HIV, both for biological reasons and because men are the ones who generally make the ultimate decisions regarding condom use. Giving women, including those in marriages that may not be monogamous, a tool to protect themselves against HIV without having to have complicit agreement from their male partner, could drastically impact the rate of HIV infection around the world. Research has also begun into microbicides that could be used rectally, an option that could benefit both straight and gay people.

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