http://www.smh.com.au/world/science/gel-offers-women-their-own-protection-from-aids-20100720-10jhv.html

Gel offers women their own protection from AIDS 
DAVID BROWN 
July 21, 2010 
WASHINGTON: A woman's risk of infection with the AIDS virus can be cut by the 
use of a vaginal gel, a study has found.

The research marks the first success in a 15-year search for a way for women to 
stop themselves contracting HIV infection through sex. Short of a vaccine, an 
effective vaginal microbicide has been the most elusive goal in the epidemic.

The research, which was conducted in South Africa and is to be presented at the 
18th International AIDS Conference in Vienna this week, tested a gel containing 
the antiretroviral drug tenofovir. While far from perfect, it was unambiguously 
helpful, cutting the risk of HIV infection by 39 per cent in a group of women 
who used it for about three-quarters of their sexual encounters. Those who used 
it more consistently experienced 54 per cent fewer infections.

If development follows the expected course, more potent formulations combined 
with campaigns to make the product appealing could bring vastly better 
protection.

Of the 33 million people worldwide infected with AIDS, 16 million are women. In 
Africa, 60 per cent are women. Nearly all acquired the virus through sex.

News of the study results, published in the journal Science, sent a wave of 
optimism through the AIDS research community.

''We have never had any kind of tool that has effectively allowed women to 
protect themselves,'' said Bruce Walker, an AIDS researcher at Harvard Medical 
School.

''It's groundbreaking,'' said Catherine Hankins, the chief scientific officer 
of the United Nations' AIDS agency, UNAIDS. ''This in combination with [male] 
circumcision in places where the epidemic is generalised could really turn the 
tide.''

Michel Sidibe, the executive director of UNAIDS, said: ''We are giving hope to 
women. For the first time we have seen results for a woman-initiated and 
controlled HIV prevention option.''

The director-general of the World Health Organisation, Margaret Chan, said the 
UN agency would work hard to speed up access to the product, once it was proved 
safe and effective.

A larger study testing tenofovir gel and antiretroviral drugs in pill form is 
under way in four African countries but will not be finished until 2013. 
Several other experiments, including ones in which the drug is in a long-acting 
vaginal ring, are in earlier stages. A microbicide might also be useful in 
protecting men who acquire the virus through anal sex.

In the study, a group of HIV-negative women (city dwellers and rural villagers) 
were randomly assigned to use a gel that was 1 per cent tenofovir or a placebo. 
A woman was shown how to inject the gel into her vagina no more than 12 hours 
before intercourse and again within 12 hours after - but with no more than two 
applications in 24 hours. Each had a monthly AIDS test.

At the end of 2½ years, there were 98 infections in the 889 women. The HIV 
incidence, measured as the number of new infections for every 100 ''women 
years'' in the study, was 5.6 in those using the tenofovir gel and 9.1 in those 
with the placebo gel.

The Washington Post; Agence France-Presse


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