Next step in HIV prevention research

Antiretroviral therapy can reduce the concentration of HIV in the bloodstream, but scientists are now turning their attention to prevention methods. Image: Shutterstock

The International Microbicide Conference 2012 looks at which methods work and the next steps in developing these.

Scientists met to discuss the current state of HIV prevention methods at the International Microbicide Conference 2012, held a few days ago in Sydney. They also examined the lessons learnt from previous trials and the challenges ahead for delivering prevention methods to those at risk of being exposed to HIV.

While treatments such as antiretroviral (ARV) medications have been revolutionary, scientists are aiming to prevent people from requiring these in the first place. Some of the possible tools are microbicides, which can reduce the effectiveness of bacteria and viruses such as HIV. They are commonly developed as gels and creams, but a recent influx of new technologies and drugs has led to the development of more application methods, including injectable products and vaginal rings that deliver products such as dapivirin, a potent antiretroviral medication which may be able to assist prevention.

Researchers discussed the results of the pre-exposure prophylaxis (PrEP) trials, an ARV aimed at lowering a HIV-negative person’s chances of becoming infected by HIV if exposed to it.  The medication Truvado has been found to provide 44 per cent additional protection if taken daily.

The possibility of developing multi-protection products was also raised. These could, for example, prevent both pregnancy and HIV, and assist with breaking down communication barriers, as some people are confused about the need to use condoms if they are already taking oral contraceptives.

There are still challenges ahead in making these medications available, such as measuring adherence (whether people remember to take or apply the products) and risk perception, dealing with cultural barriers on both sides and determining what motivates people to take the medications.

Dr Deborah Zewdie, Deputy Executive Director from the Global Fund to Fight AIDS, Tuberculosis and Malaria, also raised the issue of who will pay for the development of these methods and the lessons learnt from past trials. She said that people need to rally behind these products as the science involved creating them develops, in order for them to become a feasible option.

“You need champions, whether it’s agencies or individuals. You need people to rally behind these.”

To achieve this, researchers need to prove that these treatments will be cost effective to the organisations and individuals who will be funding it. This emphasises the importance of determining which the right products to go forward from the phase one and two trials.

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