Microbicides 2008 Conference: From Discovery to Advocacy

[Quick comment from IRMA - while we are delighted that rectal microbicide research and advocacy are covered quite nicely in this article, we would like to offer one correction. IRMA is referred to as the International Rectal Microbicide Working Group - a former, harder-to-say version of ourselves that we assigned to the dustbin at the end of 2007. We would also like to see, in future articles, the inclusion of men as end-users of microbicides. Both heterosexual and homosexual men will be using microbicides, after all, whether they are having sex with women or with other men.]

AIDS Research and Therapy 2008, 5:19doi:10.1186/1742-6405-5-19
Published: 15 August 2008

ABSTRACT

Recently revised statistics show the number of individuals living with HIV at over 33 million worldwide, with 68% being in sub-Saharan Africa. Current HIV prevention methods, such as condom use, monogamy and abstinence, are not always feasible. The need for improved HIV preventative technologies remains urgent. Of these, microbicides represent promising female-initiated preventative method. Microbicides are designed to be applied vaginally to prevent HIV and STI acquisition. Research is also being undertaken to assess the safety of the product during rectal application. The biannual Microbicides conference took place in New Delhi, India from 24-27 February 2008. The conference was open to delegates from the scientific and medical fields, as well as communities and advocates. In addition to microbicide research and development, the conference afforded the opportunity for the discussion of key issues such as ethics, acceptability, access, and community involvement. In this conference report we provide brief summaries of recent advancements made and challenges experienced in microbicide research and development, including updates on basic and clinical science, social and behavioural science, and community mobilisation and advocacy activities pertaining to clinical trials.

Click here to read the full article, open access.

The Future of Sex from New Delhi to Chicago - NEXT WEEK

Direct from Delhi - Microbicides 2008 Comes to Sweet Home Chicago

RSVP - it's FREE.

NEXT WEEK
Wednesday June 25, 2008
6:00-8:00 p.m.

University Center
525 S. State Street
Chicago

Please join the Chicago Women and Girls HIV Prevention Coalition and the International Rectal Microbicide Advocates for this exclusive update from across the globe on the current developments in microbicide research and advocacy - direct from the Microbicides 2008 conference held in New Delhi, India.

Plus be the first to here about the new International Partnership for Microbicides trial that is going to be taking place in Chicago.

Microbicides are products currently in development that a person could use to reduce her or his risk from infection of HIV and other STDs.

RSVP - it's FREE.

This dynamic event will feature microbicide advocacy leaders:

Latifa Boyce
Alliance for Microbicide Development

Dázon Dixon Diallo
SisterLove, Inc.

Jim Pickett
International Rectal Microbicide Advocates
AIDS Foundation of Chicago

[Delhi Dynamos] Nesha Z. Haniff of Ypsilanti, Michigan

Part of a Movement

to Change the World

It's a Long Road...

Correspondence from IRMA advocates

by way of India

M2008 memories and the path forward

by Nesha Z. Haniff
via Durban, South Africa
May 19, 2008

For the last two weeks I have been in South Africa doing work at the University of Zululand and in the township of Cato Crest in Durban. Both of these places are in Kwa-Zulu Natal where the epidemic in HIV rages on. The work I do with my students from the University of Michigan centers around an oral methodology to teach HIV prevention to low literate populations. I developed this method in the Caribbean about 18 years ago and brought it to South Africa in 2007. The objective was to train my students at Michigan to teach this methodology and then have them teach their peers at the University of Zululand, who then develop it in Zulu and teach their communities. So far these students have taught over 10,000 people in their rural communities. I talk about this because unlike Jamaica, where the epidemic is concentrated in segments of the population, the epidemic here confronts you everywhere, in the long lines waiting for ARVs (anti-retroviral therapies), in the numbers of students who die every term at the University of Zululand, in the numbers of children made vulnerable in the Cato Crest Primary school in the township of Cato Crest. This reality of my work in South Africa and the reality of my work in Jamaica (Jamaica AIDS Support for Life) where the HIV infection rates among MSM are astronomical, are the drivers of my commitment to microbicides. Despite the recent failures in the microbicide trials and the arduous struggle for rectal microbicides, I continue its advocacy where the constant questions are - where is it, when can I get it? The international Microbicides 2008 came at a time when I felt that my enthusiasm was beginning to wane and my microbicide advocacy speech would indeed seem like a far-away dream.

Where everyone knows its name

The conference was overwhelming - so many people all over the world gathered to discuss and inform each other about microbicides. I say to myself - so many people are here and so few people even heard about microbicides. When I speak about it in Jamaica and to my students in the U.S . who are in Women’s Studies or in the School of Public Health, no one has heard of microbicides, so to be in a place where everyone knows about it and debates it made me feel less lonely and part of a movement to change the world.

I was in India again after 25 years ,when I was there as a very young woman. Even though I didn’t get a chance to do very much, I could feel the difference in the Delhi-then and the Delhi-now. I felt that it was a place on the move, on the cusp, a city modern with a culture so powerful that if it won’t rule the world, it is certainly at the moment profoundly influencing it. Everyone to me looked beautiful, even the poorest person was wrapped in color, I was constantly assaulted by the many beautiful sounds and sights. I was so appreciative to be in India and to drink it in.

The questions around adherence

The conference itself was a classroom and I loved particularly the D track sessions (on advocacy and community engagement.) These were people on the front lines of the epidemic and their insights and experiences were instructive and demonstrated the disconnect between the science protocols and ethics and the practitioners on the ground. I remember a great debate about adherence and the use of incentives. How do you encourage participants to adhere with token rewards instead of solid monetary incentives? The crux of this question is still troubling and at the center of the current debate around the trial of giving monetary rewards to people who do not become infected. For me this question must be resolved. How can scientists who are the greatest beneficiaries of trials and interventions, whether they succeed or fail, ask the poorest people to participate for the greater benefit of their societies while the scientists reap immediate benefits, publications, grants, travel, promotions? This was not the exact debate but it was a very lively discussion about the problems of practitioners achieving adherence to study protocols with incentives that are not enough to sustain adherence.

I was especially informed by the pre-meeting that covered the new research on rectal microbicides and learned a great deal from those sessions. The work being done at the University of Pittsburgh and UCLA is impressive and innovative, although I would like to see more women participating in anal intercourse studies since this population is also at risk but notat this stage as present in scientific research. We cannot assume that the anal intercourse event is the same for men and women even if the physicality appears the same, and even this physicality must be challenged.

Old school ≠ irrelevance

The sessions on gender and new technologies were disturbing for all the papers reiterated the severe disadvantages that women face in the epidemic. The male paradigm of science and how it affects women’s health was highlighted in Catherine Hankins presentation in one of the opening symposiums. I thought that the re-examination of the diaphragm as a choice for women was important in advocating for already available technologies. The redesign of the diaphragm and the female condoms are necessary and immediate priorities. This “old school” technology is not irrelevant.

I was struck by the priority given to the scientific presentations as opposed to the praxis and cultural presentations. The venues were better, the presenters were on stage, the rooms were larger. I think to some extent it represented the schism in current microbicide work - the disjunction between privileging scientific studies over behavioral cultural studies. Unless the social sciences are more incorporated in microbicide studies then the problems of adherence will continue and social scientists will continue to feel marginalized over the big important science.

The emergence of ARVs

Perhaps the most interesting thing I got from the conference was the emerging viability of ARVs as a method of HIV prevention . The implications of this research meant that now HIV positive people can become involved in the development of this new method since drug resistance becomes pivotal, and that the complexities and difficulties of the vagina in developing a vaginal microbicide can be circumvented. This still leaves us with a paucity of studies on the vagina and again reveals the sexist nature of the current state of science and women in 2008.

I appreciate the support of IRMA in attending this conference and becoming one of the first John Shaw scholarship recipients. I was honored to be selected. Last week I gave an open lecture at the University of Zululand on new prevention technologies and gender. It was very well received. It has occurred to me that perhaps now the word is no longer "microbicides" but "new technologies." Somehow I think this is a tacit acceptance that the microbicides struggle is a long haul and that new technologies simply mean now a reworking of old technologies and the hope that ARVs will come to the rescue.

It is indeed a long road and I when it gets lonely I remember India and that we are part of a movement to change the world.

Read other Delhi Dynamo entries.

Check out IRMA's photo set from the M2008 conference here.

Did you attend M2008 and want to add your photos to our growing collection? Send Jim Pickett of IRMA a note with your photos attached and they will be included.

[Delhi Dynamos] Lanre Onigbogi of Ibadan, Nigeria

More Grease to Your Elbows!
Proud Member of IRMA Puts Rectal Microbicides
on the African Map

Correspondence from IRMA advocates

by way of India

M2008 memories and the path forward

by Lanre Onigbogi

I had always wondered what it would be like visiting the Asian continent and M2008 provided that opportunity. As a rectal microbicide advocate and an IRMA scholarship recipient, the challenge could not be bigger because there was so much to look forward to about the conference. The excitement was further heightened by the fact that my exposure to rectal microbicide sessions at M2006 had generated my venturing into research related to rectal microbicides. I wondered whether my exposure to the rectal microbicides sessions in this meeting will heighten my curiosity about the subject or totally dampan my enthusiasm. In summary, I was not disappointed and could not have wished for a better conference. 

The apprehension about how the rectal microbicide sessions and how to combine that with the volunteer efforts at the advocate corner was too overwhelming to be hidden from colleagues who were also participants at the meeting. This was heightened by the fact that I had made up my mind to talk to some Nigerian delegates about the International Rectal Microbicide Advocates (IRMA), an area that was hitherto novel to many of my colleagues.

Anecdotal reports put it that many who came without ever hearing about rectal microbicides ended up signing up to be advocates.

The M2008 conference itself was a great success. If we can learn from this conference and support the development of research on microbicides and convince investors to invest more in these, it would be a great achievement. There were also many youths, especially really dynamic ones from Africa who I believe will grow up to become great advocates. Simply put, youths are the best investment in the future of our nations, as they are healthy and fresh workers. The rectal microbicide agenda was also a greater success. Anecdotal reports put it that many who came without ever hearing about rectal microbicides ended up signing up to be advocates. Quite an achievement bearing in mind the stigma that is still associated with homosexual relationships in many parts of the world.

We need to look at the research agenda of the conference so that African universities can do operations research and evaluate their rectal microbicide programs. I look forward to a cohort of researchers and advocates who will come out of Africa and will collaborate to get funding for rectal microbicide research and advocacy. 

Since coming back from Delhi, I have picked up the responsibility of editing the Quarterly Newsletter of the Nigeria HIV Vaccine and Microbicides Advocacy Group (NHVMAG) called the NHVMAG Echoes. We are in the final stages of producing the newsletter that will highlight activities at M2008, and the success of advocacy efforts by IRMA will be showcased. I also look forward to participating in the rectal microbicide sesions of the AIDS 2008 conference in Mexico City later in the year as well as further involvement in rectal microbicide research and advocacy.

My heartfelt gratitude goes to the steering committee of IRMA and the indefatigable Jim Pickett for working tirelessly to put the rectal microbicide agenda on the main table, thereby potentially saving many valuable lives of African women and men.

More grease to your elbows!

I am proud to belong to IRMA and will forever be grateful for this wonderful opportunity to attend M2008 and look forward to seeing you all in Pittsburgh!

Read other Delhi Dynamo entries.

Check out IRMA's photo set from the M2008 conference here.

Did you attend M2008 and want to add your photos to our growing collection? Send Jim Pickett of IRMA a note with your photos attached and they will be included.

[Delhi Dynamos] Shaleena Theophilus of Ottawa, Canada

Renegade Daughter and Microbicide DIVA
Makes Subcontinental Advocacy Magic

Proves You CAN Go Home
And Walk the Talk

Correspondence from IRMA advocates

by way of India
M2008 memories and the path forward

by Shaleena Theophilus

Thanks to the generous funding by IRMA through the John Shaw Memorial Scholarship, I was able to attend the Microbicides 2008 conference that was held in New Delhi. For me, these conferences are so amazing because you not only get to attend sessions on the latest in the field of microbicides research, you also get to genuinely interact with people from all sectors invested in microbicides advocacy from around the globe. How amazing is that!

I did my usual conference routine of trying to attend at least one session from every track. I had to stretch my mind a bit for the basic and clinical sciences, but overall, the information that I brought back was useful and informative for the work that I will be doing here in Canada.

Now, being an Indo-Canadian, this conference held an added importance to me. I had not been back to India for 13 years (as my family who still live there reminded on every occasion possible) and seeing how it has changed and the impact that this disease has had was something that I find hard to describe. In Canada, there are a handful of us -- South Asians working in this field. I found it inspiring to be surrounded by other Indians who are not only committed to the cause, but who also have an interest in microbicides.

Heading off after the conference, I had wished that more delegates could have seen Delhi beyond the confines of the conference, and experienced India in all of its intensity. I left to visit the plethora of aunties and uncles in the south, and I found that attending Microbicides 2008 afforded me the opportunity to talk with many of my relatives about these issues. I secretly chuckle when I think of my mother finding out that I talked about sex to her childhood classmate. However, I guess it is the smallest things that can have the biggest impact, whether that be giving a renegade daughter a secret pleasure or changing a person’s perception and actions around this disease.

Back in Canada, I have already had the opportunity to share what I had learned with the Canadian Microbicides Action Plan steering committee, as well as the Microbicides Advocacy Network Group. I will also be incorporating this information into upcoming presentations, the next of which will be held for community members in Nova Scotia at their regional skills building conference.

I look forward to the next conference in Pittsburgh. More importantly, I look forward to one day showing community members what a microbicide looks like and how to use it both vaginally and rectally as the newest prevention option available to them!

Read other Delhi Dynamo entries.

Check out IRMA's photo set from the M2008 conference here.

Did you attend M2008 and want to add your photos to our growing collection? Send Jim Pickett of IRMA a note with your photos attached and they will be included.

Moins de silence, Plus de science

IRMA is thrilled to see that the PlusNews article about the launch of Less Silence, More Science: Advocacy to Make Rectal Microbicides a Reality is available en français!

« Moins de silence, plus de science » pour rendre le sexe anal plus sûr

NEW DELHI, 28 février 2008 (PlusNews) - Le silence et les tabous qui entourent les questions liées aux relations sexuelles anales exposent des millions d’hommes et de femmes au risque VIH, ont plaidé cette semaine des intervenants à la quatrième conférence internationale sur les microbicides à New Delhi, en Inde.

Souvent considérées uniquement comme une « chose de gays », les relations sexuelles anales sont aussi pratiquées par des couples hétérosexuels, très souvent sans protection, comme l’ont montré plusieurs études, a noté Jim Pickett, président du Rectal microbicide advocates (IRMA), qui a rendu public un rapport sur ce sujet lors de la conférence.

Le rapport, « Moins de silence, plus de science » (Less silence, more science, en anglais) avertit que les chercheurs ne peuvent pas se permettre d’ignorer plus longtemps la question des relations sexuelles anales, l’un des principaux vecteurs de l’épidémie, et appelle à davantage de recherches dans le développement d’un microbicide rectal...

Pour le reste de l'article, consultez le site Web de IRIN

[Delhi Dynamos] Bill O'Brien of Boston, USA

Bringing it Back to Boston

Baked Beans and the Future of Anal Sex

Correspondence from IRMA advocates

by way of India

M2008 memories and the path forward

by Bill O'Brien
[read Bill's bio]

My trip to New Delhi and the Microbicides 2008 conference was an exciting one for me. It wouldn’t have happened without the generous support of IRMA and the John Shaw Memorial Scholarship and the conference scholarship I received. I definitely need to thank everyone who provided me with financial support to make the trip.

This was my first trip to Asia and New Delhi is a city unlike any that I had ever been to before. The sheer size, both in area and population, I found amazing. I won’t soon forget weaving in and out of traffic in the back of a taxi or all the animals on the street. I was a bit disappointed that I never got to see a monkey.

The conference itself had some organizational issues but overall, looking back, it went well. It was great seeing the entire microbicide field in one place and meeting many IRMA members.

Now back in Boston, I’ve shared my experience at the conference in many ways. I spoke at a department staff meeting and sent out an informational email to staff at Fenway with links to microbicide resources including the IRMA website.

In May, I have been invited to speak at a Massachusetts Department of Public Health (MDPH) meeting. At the MDPH meeting, I will discuss microbicides and will share my experiences at the conference. I look forward to maintaining my relationship with IRMA and continuing my microbicide advocacy work here in Boston.

Hopefully, I will see everyone again in Pittsburgh.

Read other Delhi Dynamo entries.

Let's Hear Those Voices! Let's Have Choices for Everyone Who Needs Them!

Why should we prioritise the needs of one group of people over the needs of other groups of people?

by Jo Robinson

Terrence Higgins Trust

UK

I’ve enjoyed some of the fall out discussions from the International Microbicides Conference in Delhi, that have appeared in my inbox via several lists. It’s got me thinking a bit, particularly about how we communicate messages around microbicides, and how we talk meaningfully about microbicides, without reinforcing stigma and prejudice of those living with HIV, and other marginalised groups of people.

I’ve been picking up on this message that has been around for a long time, that the primary target audience for an HIV microbicide is HIV negative women living in Africa, and other places where HIV prevalance among the general population is high. Nothing wrong with that you might argue, but... IS THERE something inherently wrong with it?

My initial introductions to the microbicide field were in 2001, and shortly after I attended my first International Microbicides Conference in Antwerp, Belgium, in 2002. At or around this conference the International Partnership for Microbicides (IPM) was launched, and it was all very exciting news. I was a new fresh young microbicide activist - There were a few of us back then, as opposed to the enormous movement that has been created today I’m pleased to say!

We lapped up messages, had fantastic discussions, started working on materials to disseminate, and hooked up with Global Campaign for Microbicides (GCM) and realised we had in GCM an organisation that wanted to work in partnership, and was interested in a diverse range of voices from the community.

But that was six years ago and a lot of work has happened in the field, and times have changed. HIV has I’m sad to say, advanced in our communities, HIV prevention work has advanced, messages have changed with the times. Things have moved on, so how do we stay up to date and on the edge? How do we make sure that people at the cutting edge of HIV prevention and sex and relationships stay at the centre of community mobilisation around microbicides? How do we make sure our voices are heard globally when we don’t work for an international organisation or have a marketing budget? Well, the IRMA blog is a very welcome opportunity to share some of our thoughts I think.

So, are microbicides still for HIV negative women only? Well, the work that IRMA is doing clearly challenges that notion in different ways. What springs to my mind when we prioritise one group of people’s needs over another is that in HIV prevention terms this makes no sense whatsoever. Playing people off against each other is distrastrous for the health and wellbeing of people in different communities.

Why should we prioritise the needs of one group of people over the needs of other groups of people?

It doesn’t seem very human rights-based, does it? It’s counter-intuitive to me to think about a hierarchy of needs. Most people that are living with a prevalence of HIV that is high among their communities or sexual networks, have pressing needs around HIV transmission – either avoiding passing HIV, or avoiding getting HIV, so let’s try and focus on the needs of all of them and try to hold them all in mind – plenty of others will try to divide us. I’d like to see us be a little bit more united. The great thing about the microbicides movement is that here is an issue and a product or set of products that are of interest to us all, and as such they have the potential to unite us all in favour of a common goal, namely promoting the health and wellbeing of people with HIV and communities affected by HIV.

Here in the UK, we have moved on a lot in the past six years. Our HIV prevention messages are now much more targetted at people with HIV as well as those that do not have HIV. We have had to carefully avoid messaging that excludes people with HIV because we’ve found that that reinforces stigma and prejudice, often making it harder for those people to negotiate the type of sex they want – be it protected or unprotected, and that’s the last thing we want to do. The vast majority of people with HIV are highly motivated to avoid passing on HIV, but it doesn’t mean they do not have a variety of complex sexual health needs and a large need for support around sex and relationship issues.

I question if we should be so blatent in our messaging and thinking about microbicides as a tool that will “primarily” help a particular group of people.

Women without HIV might well be the “targets” of something new, but will they actually be the first to use it? I suspect that gay men in their droves will be picking up any new microbicide product, because using lube for sex is so common among men (and women) who have anal sex (and much less common in comparison among people who have vaginal sex).

The people that will be most interested in a new HIV prevention tool will also be living with HIV themselves. Time after time I’ve been around people with HIV who are motivated around HIV prevention, and want to take advantage of anything that will make passing on HIV less of a “big issue to worry and think about” when they have sex with partners that don’t have HIV. For some, condoms, work, but choice would be nice!!

So, I think we should be careful if we think about hierarchies of communities and needs. Why are HIV negative women more deserving? Because there are more women getting HIV than men? Well, HIV prevalence in certain communities of men who have sex with men in a range of cities around the world is on a par with prevalence in some of the high HIV prevalance countries in Africa for example, so let’s think about prevalence in a broader way, and target our resources where they are equally needed.

If I were thinking about messaging around microbicides in the gay community, would I want to prioritise the needs of receptive men or “bottoms” rather than “tops” or “insertive” men?

Do they have different needs? Should I say, this is primarily for the “bottoms”, but, oh, yeah, we best make sure we at least tell the “tops” about it? I suspect what we’d want to do is make sure we had included everyone, because sex usually takes two or more people! I’d want to see microbicides as a uniting factor for the community, because they will help insertive partners as much as they will help receptive partners.

Many have argued that women need something that they can use without their partners knowing, but practically speaking, this is probably counter intuitive to many women, as much as it will be intuitive to some. Many have argued that violence, coercision and power dynamics all have their part to play in why we must develop something that HIV negative women can hide from (the assumption goes) their HIV positive male partners. Whilst this might be important to some women in some situations, it’s a lot more complex than this I suspect for many, and this type of story if we buy into it reinforces the message that HIV positive men are in some way predatory and only interested in unprotected sex at any cost– surely a stereotype that we ought to be fighting, rather than reinforcing?

In the relationship workshops I’ve been priveleged to run, with women and men with HIV, most talk about love, trust, caring about each other and intimacy, and that negotiating and talking about the sex they want is a problem, and it’s not a problem that will go away unless they have choices and strategies to deal with it.

If a microbicide gives me other choices, and is something I can use whether we talk about it or not, that’s a good thing. But why is an HIV negative women’s need more important than an HIV positive man’s right to have different choices around how to avoid passing on HIV? Where is the group that is demanding a microbicide because it will expand options for straight men with HIV? Or gay men who are insertive partners during in sex? After all, there are plenty of women out there arguing that we should have better male condom distribution schemes, - even though they won’t necessarily be putting them on themselves!

So many different audiences, so many different voices, but let’s here those voices!

What’s my marketing message going to be?

What message would you give men with HIV when it comes to microbicides?

“Fumbling around with a condom? Why not take it as it comes with a gel!”

[Please feel free to comment and keep this important discussion going!]

SFAF Podcast on Microbicides

In this episode, Dr. Judith Auerbach, Deputy Executive Director for Science and Public Policy at the San Francisco AIDS Foundation, discusses findings revealed at the recent International Microbicides Conference in New Delhi, India. After a few disappointing setbacks, current microbicide research and trials are beginning to yield results that may lead to another effective HIV prevention tool.

Listen to SFAF.org Podcast #30 - Dr. Judith Auerbach on current HIV microbicide research. (8 minutes)

Auerbach is responsible for developing, leading, and managing the San Francisco AIDS Foundation's local, state, national and international policy agendas. Prior to joining the Foundation, Dr. Auerbach served as Vice President, Public Policy and Program Development at amfAR, The Foundation for AIDS Research.

Moving Forward with Rectal Microbicide Advocacy in Nigeria

Your Support is Appreciated!

by Sholotan Abdulrahaman Oladimeji

I am writing to tell you that after I learned about International Rectal Microbicide Advocates (IRMA) in India during the Microbicides 2008 conference, I decide to form my own Youth Organization and IRMA Club at the University of Calabar and in Lagos here in Nigeria.

Also, I want to organize a Post Microbicide Conference Seminar in both cities in order for me to disseminate the knowledge gained during the conference among my fellows students and to the community in general, so that some of them will have the opportunity to know more about IRMA. This seminar will show ase the new research for prevention of HIV/AIDS and some other transmitted diseases.

These will involve a lot of activities like raising awareness about various issues around rectal microbicide s through Street Football Competition, Street Jams, and rallying events using a range of campaign tools.

I will need financial support and will appreciate anyone who is able to assist me in carrying out the post M2008 seminar successfully.

"LET STOP THE VIRUS AND SPREAD THE NEWS"

Sholotan Abdulrahaman Oladimeji
Official IRMA blogger
Lagos, Nigeria

[read another post by Sholotan]

*** Please leave a comment here you are able to offer support to Sholotan with his efforts.

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.

Read the rest of the article.

[Delhi Dynamos] Kadiri Audu of Lagos, Nigeria

Correspondence from IRMA advocates
by way of India

M2008 memories and the path forward

Taking rectal microbicide advocacy
to the next level in Lagos

by Kadiri Audu, Lagos. Nigeria
[read Kadiri's bio]

First, I want to thank the organizers of Microbicides 2008, IRMA, AIDS Foundation of Chicago and the John Shaw Memorial Scholarship fund that gave me the opportunity to attend the M2008 in New Delhi.

New Delhi is beautiful and the weather was just alright. I do not know if there is any better place to have hosted the conference in India, the conference was exciting and wonderful. It was interesting to have met new advocates from other parts of the world, and it was also interesting to know that people from the developed world like the USA and Canada are actually leading the research on rectal microbicides. Also, the Advocates Corner was a splendid idea because it gave the John Shaw Scholarship recipients, new advocates, and other IRMA members the chance to meet one another and build networking links among ourselves. My favorite memory was the chance to meet other advocates and the dinner organized for the conference participants.

I have been sharing my experience of the conference with members of the various networks that I belong to in our meetings. In addition to sharing my experience, I also share some materials that I collected at the advocates corner, i.e. stickers, pens and posters carrying the message about the conference.

In taking rectal microbicide advocacy to the next level, we have already formed Lagos IRMA, the aim is to mobilize more advocates in line with IRMA research and activities. We have even started e-mailing in that regards - our email address is lagosirma@yahoo.com, myself and Abdullrahaman formed it. He is also a new advocate that attended the conference and we operate from the same city. As of today we have 21 new members from our community.

Presently we are looking at reaching out to more people and groups like the youth leaders, the artisan groups like the hair dressers association, barbers association, the auto mechanic association, etc within our locality.

I would also like to suggest that we have training opportunities for us and our new members so as to be able to carry on the work effectively.

Thanks once again.
Kadiri Audu E

[remember to visit www.rectalmicrobicides.org - IRMA's home on the web!]

[Delhi Dynamos] Sholotan Abdulrahaman Oladimeji of Lagos, Nigeria

Correspondence from IRMA advocates
by way of India

M2008 memories and the path forward

Delays don't slow this dynamo down!

by Sholotan Abdulrahaman Oladimeji

Hello,

I am Sholotan Abdulrahaman Oladimeji from Nigeria and I want to tell you about my experience at the Microbicides 2008 international conference in New Delhi, India. I had a really great time at the conference . It was the chance of a lifetime and opportunity to travel to India to attend this great international conference that involved pupils from all over the globe.

My trip to New Delhi was exhausting because I left Nigeria on the 22nd of February, 2008 at around 1:40 pm and I made the first stop over at the Bole International Airport in Ethiopia and I had to wait for an hour before getting the connecting flight to CSIA International Airport in Mumbai and after getting there it was around 05:45 am Nigeria time. I had some delays at the CSIA Airport, because the International Airport terminal was undergoing a massive renovation and some major part of the main terminal was closed. Due to this delay I missed the flight to New Delhi and I had to wait at the their local airport for like five hours and the most funny aspect of this was that one of the airline officials said that I had to pay some for having missed my flight. I led them to understand that it wasn't my fault and that it was due to the delays I encountered at the CSIA International Airport.

I arrived at the New Delhi airport and I passed through the immigration. Yhen I went to collect my baggage. What I saw next were the staffs from the conference with a large "MICROBICIDES 2008" sign. Anyway I got over that and I made my way to the hotel. On my way to the Le Meridien hotel, I felt so at home and it then struck me that this city was no different from Lagos, except for the motor part with other road users. Getting to the hotel that was among the most unforgettable experience I had in attending M2008; because I had never dreamt of sleeping a nite in a five star hotel at my young age, talk less of four good days, praise thy Lord "Allahu Akbar".

On the conference day which was on the 24th of February, 2008, I left Le Meridien Hotel for Ashok Hotel were the conference took place around 7:45 am Indian local time. After getting to the place, I went straight to the registration stand to collect all the conference material and I looked at the conference highlights. I decided to join the Rectal Microbicide Update Symposium. Rectal microbicide research and development is important, because it is an alternative approach to prevent both men and women for transmitting diseases.

I believe that both men and women that participated in the M2008 learned more than they had thought possible and left with some unforgettable memories.

My impression was that microbicide development is very much about empowering women. However, this conference highlighted the importance of engaging men and some of the abstract presentations showed us the challenges of involving men who were resistant to changing sexual practices. My understanding was that when men are engaged in the trial process with their partners there is more likely to be compliance of gel use.

Rectal microbicides will be important to men and women and more particular interest in Lagos, because many pupils in this city context, as HIV in the city is transmitted through anal intercourse without the use of a condom, and primarily in MSM communities. Human sexuality is extremely complex but I believe that rectal microbicides will offer a harm reduction method for most of the people who want to have sex the way they want. People have dangerouos sex because they find it enjoyable, more enjoyable than safe sex. For some people, no prevention program will change their behavior but rectal microbicides might allow for an alternative form of protection.

My only caveat is I was not able to attend everything. There wasn't time for cloning but I covered as much as I could, and more than I had anticipated.

In my free time, I read, watch premiership football league and do some searching on microbicide news and articles.

Sholotan Abdulrahaman Oladimeji
Official IRMA blogger
Lagos, Nigeria



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Send us your M2008 photos!

Many thanks to IRMA members Jerry Galea and Arwa Meijer for sharing their wonderful pictures from the Microbicides 2008 conference - such as the lovely one shown here of Manju and Bindiya (from Arwa.)

Please send us YOUR PHOTOS and we will happily include them in the Delhi and IRMA - Microbicides 2008 set we have put together on flickr (look to the left and you will see a selection.)