Anti-HIV gel

[highlander]

From the time blog:

A development that is being met with perhaps less restrained enthusiasm, however, is the finding that an antiretroviral vaginal gel may significantly cut the risk of HIV transmission for women. The study, which will be published in the journal Science, included 900 women from South Africa who were given a gel containing the anti-retroviral drug tenofovir to use before and after sexual intercourse. The researchers found that, at the end of the study, use of the gel cut infection rates by 39% overall — but that, among women who used the gel consistently and as directed, infection rates were cut by 54%.

As the Washington Post reports, news of the findings prompted enthusiastic responses in the AIDS research community, particularly in light of previous unsuccessful attempts to develop a gel that women could use to cut infection risk. As Dr. Bruce Walker, who researches HIV and AIDS at Harvard Medical School, told the Post:

"We have never had any kind of tool that has effectively allowed women to protect themselves... This is really a game changer."

We have had false starts in this area before-but this looks promising.

It would need to be combined with something like condoms and/or serosorting.


Here is the abstract to the journal article:

This figure is for 2.5 years. That means that this technique would be much more effective on a per use basis.

This figure is roughly half as much as we might expect from condoms by themselves under the best circumstances
in a similar period.

For folks who have an occasional experience outside a regular partner, this might help quite a bit.

[Alura]

According to an article in the Tulsa World this morning, the problem was that the subjects did not use the gel consistently. Therefore, the ability of the gel to protect is unclear even though positive results were shown.

Alura

[socolais]

I saw this in the news yesterday, I hope it turns out to be as real as the data tends to suggest. I also hope it doesn't taste bad

[Edison Carter]

Okay, here's the problem and I'm saying this as a scientist. The problem with the spread of HIV in Africa is not vaginal intercourse. The problem is the commonplace practice of anal sex. It's common for a variety of reasons, that I won't go into here. Then there's the problem of getting people to use the gel.

Several years ago there was a major commitment to get HIV drugs to Africa. These drugs were becoming easier to produce, lower costs, patents expiring, some induced good will, etc. The problem is that you have to take them in a timely manner and the significant issue was that there were key cultural obstacles because the people most affected didn't wear time pieces and the concept of taking a pill every so many hours was not only completely foreign to them, it was nearly impossible for them to process as adults. It's getting better, but it's a challenge.

Cultural obstacles are often nearly insurmountable. For Asia a yellow rice was developed that was much stronger nutritionally than plain white rice. Some nutritional diseases could be nearly eliminated. Yet, the idea that only white rice was good rice could not be overcome in the areas where the new rice would have done the most good.

So much of the world is so far removed from any advancement in technology or medicine and cannot grasp it. Recently a friend of mine said, "Wouldn't it be great if you could back in time 500 years with what you know today ?" I replied that the masses would be at my door yelling , "Witch ! Witch !"

And despite that, we gotta keep trying.

[highlander]

well, what percentage of sex in Africa would you guess is anal sex? How is that distributed by community?

The gel+circumcision theoretically might slow spread of HIV by 25% together. I've seen some serious pieces that suggest parasites and some other cofactors peculiar to africa are also major factors.

That said, I suspect there are some subcultures in Africa that are capable of adapting to the new situation. I've heard for example that some specific sects in africa are expanding with the sales pitch that their religion is less vulnerable to HIV by virtue of how they deal with sex education. I somehow think that gel w/o anal sex+circumcision+serosorting may be easier to sell than condoms (and if you put them together, probably more effective)-but I have NEVER been to africa and don't claim expertise in that area.

[realcplub2]

The other factor left out of the articles and news stories reporting this gel

Its a boon for those that use it in Africa, but, thats supposing a few facts not in evidence. As edison pointed out Anal sex but more over, how many horro stories come out of the country about rape gangs.. They arent going to stop a moment to allow a subject to insert a tube of gel

More over its in the "urban" areas that this course of treatment is available..

Do the results seem promising, YES.. but its a sugar coated quick look at One tiny corner of the continent

And lets ask one other question we hear deal with on a regular basis..If you arent sure about someone, why are you sleeping with them?

Is this gel going to make a difference in the "industrial" countries? Its a prevention, not a cure.. Does it make sex safer YES, but its not going to help if its already too late

[Fundamental Law]

A physician's perspective...
It's a promising first report. The general experience in new medications, procedures is initially exuberant enthusiasm followed by high profile skepticism and finally a more nuanced appraisal of indications, risks, benefits and alternatives.

The report signifies progress and I expect that the gel can be used to modify risk. But it is not and never will be fully effective at preventing transmission of the virus.

[highlander]

Originally Posted by Fundamental Law

The report signifies progress and I expect that the gel can be used to modify risk. But it is not and never will be fully effective at preventing transmission of the virus.

Nothing except abstinence provides complete protection against transmission of HIV. At least 1/3 of married couples where both parties think they are monogamous are NOT.

The big news here really:this will make for condoms that are 85% effective in typical use to something like 93% effective(I wonder if they will require a prescription?)?

I can believe in time, they will make something 90% effective-and that would be something it is easier to get folks to use than condoms.