There were cheers and some tears at the International AIDS Conference in Vienna in July when delegates heard the news that a clinical trial in South Africa, had found a vaginal gel containing the antiretroviral drug, tenofovir, was 39 percent effective at reducing women's risk of contracting HIV during sex.
"There were tears from many people – tears of happiness that finally there is something we can work towards - and a lot of tears of sadness for all of the women whose lives have been lost waiting for a microbicide," Dr Zeda Rosenberg recalled at a recent meeting in Johannesburg, South Africa, hosted by the International Partnership for Microbicides (IPM), a non-profit organization.
IPM is involved in coordinating and funding the long process of developing effective microbicides - products that women can apply vaginally to protect themselves against HIV - and making sure they reach the women in developing countries who most need them. Rosenberg, who has been working in the field of HIV prevention research for more than two decades and is CEO of IPM, talked to IRIN/PlusNews after the meeting.
QUESTION: What do you think is the likelihood that women will use a microbicide any more consistently than men use condoms?
ANSWER: Part of the issue with condoms is that although they're highly effective, many people put a large value on skin-to-skin contact and ... in long-term relationships it just seems that condoms aren't used as often because it's a trust issue, an issue of intimacy; and also, if everyone uses a condom all the time, women can't get pregnant.
So there really does need to be a method that women can use where they and their partners don't feel it reduces intimacy, allows for conception, and is culturally acceptable.
I think microbicides need to be marketed with the message: 'Condoms should be used', because you don't want a less effective microbicide replacing highly effective condoms. At some point there will be all of these partially effective methods that, when used together, will be highly effective.
Adherence was a challenge in the [South African] trial - those women who reported greater adherence had greater efficacy. [The investigators] also saw a drop-off in product use over the course of the study, which means you need something that's sustainable in the long term.
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