Monday, October 13, 2008

A slippery hope - "Love is stronger than death."

Gus Cairns (left), a writer and advocate just profiled in the Advocates section of the IRMA website, interviewed Dr. Robin Shattock (pictured above, far left) of St. George's Hospital in London for Positive Nation. They discussed new prevention technologies and, specifically, rectal microbicides.

Here is an excerpt:

Positive Nation: Talking about gay men, how are we doing in trying to find a microbicide for anal sex?

Robin Shattock: We’ve come amazingly far considering how little funding there is in the field – funders don’t like paying for research into anal sex. In animal studies we produced really promising results showing that a product that wasn’t ideal – it was designed as a vaginal microbicide – stopped more than half of potential infections in a situation where all the monkeys involved should have become infected. I thought it would have no chance of working; we know HIV loves to infect intestinal cells and the gut is a huge area to cover compared with the vagina. Now, I actually believe a rectal microbicide will work, and with enough investment I’m very optimistic we’ll be able to develop an effective one.

The key will be in the funding. We’re halfway through an initial safety trial in humans using a third antiretroviral, a drug never developed for oral use called UC-781. This has produced initial results that look very promising - but that’s using 36 volunteers. We’ll need an exponential increase in funding to do an efficacy trial.

In the meantime, we may get a positive result from the PrEP trials, and clearly PrEP will have a place in high-risk individuals. But it involves taking doses of drugs that are just as high as those used in HIV treatment and if you’re giving them to HIV negative people you have to set a much higher standard for toxicity and the possibility of developing drug resistance.

The full, wonderful, interview can be found on Positive Nation here.

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