If We Can Make it There... New York Times Goes Rectal!

New Lines of Attack in H.I.V. Prevention
via New York Times, by Donald G. McNeil, Jr.

[McNeil gets things a little confused overall in this article, sometime a bit fuzzy on the facts, but this has to be the most the New York Times has ever written on rectal microbicides, beyond the one word - "rectal." This is pretty major - the rectal agenda has made the Times!]

Rectal excerpt:

Because 95 percent of gay American men and 40 percent of heterosexual American women have had anal sex at least once during their lifetimes, according to surveys, rectal versions of the gel are being developed. Tests of new, less viscous formulations that are less likely to draw water into the rectum, making use unpleasant, will begin soon, said Dr. Ian McGowan, another leader of microbicide trials at the University of Pittsburgh’s medical school.

Gay and bisexual black and Hispanic men, who are now the highest AIDS risk groups in the United States, will be recruited soon in Boston, Pittsburgh and Puerto Rico to see if they find the gels acceptable, he said.

But first it is crucial to make sure gels don’t inflame the rectal lining, which is more fragile than the vagina’s. Since H.I.V. zeros in on activated immune cells, inflammation increases infection risk. Brief tests of irritation and acceptability will be done on people advised to remain celibate during the tests, he added. Larger trials, in which thousands of men and women regularly practicing anal sex are given gel or placebo will not begin for two to three more years.

“The rectal microbicide field is about 10 years behind the vaginal one,” Dr. McGowan said.

That is partly due to misconceptions.

“When you mention rectal microbicides, a lot of people say ‘Oh, come on,’ because they think you have to protect the whole colon, and it’s meters long,” Dr. McGowan said. In fact, researchers believe protecting only the last six to eight inches will suffice.

A 2008 British study showed that rectal tenofovir gel was very protective in monkeys that were then given anal doses of the virus that causes simian AIDS.

Read the rest.


[If an item is not written by an IRMA member, it should not be construed that IRMA has taken a position on the article's content, whether in support or in opposition.]

Pitt working on microbicides formulated as films/strips

via Pittsburgh Tribune-Review, by Luis Fabregas

Borrowing a concept used to make breath strips, researchers at the University of Pittsburgh are developing a quick-dissolving vaginal film containing an HIV-blocking drug, officials said Wednesday.

"The idea is that it would dissolve quickly in the vagina to prevent HIV infection," said Sharon Hillier, a senior investigator at Magee-Womens Research Institute and co-principal investigator of the project. "It's a bit of an old technique, like the Listerine breath mint strip, but it's a whole new way of delivering the drug potentially in a less expensive way."

Read the rest.

Scientists Debate HIV Prevention Products - NPR today

[NOTE - not a word on rectal microbicides, and a rather pessimistic take on microbidide development from the Gates Foundations's Tachi Yamada]

via Morning Edition, March 10, 2009

For years now, scientists have tried to find a product that would give women in developing countries more control in protecting themselves against sexually transmitted HIV. They have yet to find a universally effective and safe method.

A recent study presented at the Conference on Retroviruses and Opportunistic Infections in Montreal highlighted the dilemmas in this field — a gel to prevent HIV worked in 30 percent of the women who tried it. Many scientists have dismissed those results because there was a 1-in-10 chance that the effect was due to chance. Others who had great expectations riding on the findings were encouraged.

Still, Tachi Yamada (pictured), director of global health policy for the Bill and Melinda Gates Foundation, was concerned that the results were presented as promising.

"To me, it was very unfortunate," says Yamada. "In fact, there should be a little bit of concern that this is now the fifth or sixth trial that came out statistically insignificant."

Read the rest.

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