16 November 2011

Zimbabwe: Another Form of Women Microbicide for Trials

Following the low success rate of the first run, local researchers have taken aboard another form of microbicide for trials.

Microbicides are products being developed that women could use vaginally to protect themselves from HIV and possibly other sexually transmitted infections.

Many sexually active men are taking up the free circumcision option being offered in various centers countrywide. Male circumcision is believed to reduce HIV transmission rates by up to 60 percent.

A microbicide could be produced in many forms, including gels, creams, suppositories, films, or as a sponge or ring that releases the active ingredient over time and could be the most important innovation in reproductive health since the Pill.

Although correct and consistent use of male condoms has been shown to prevent HIV infection, women often have no power to negotiate for safer sex hence introduction of the microbicides.

The University of Zimbabwe in collaboration with the University of California San Francisco (UZ-UCSF) project director Dr Nyaradzo Mgodi said the trial, involving the vaginal ring is still in its preliminary stages but is expected to be rolled out beginning of next year and will run for two years.

Dr Mgodi said the vaginal ring contains dapivirine - an anti-retroviral drug - and can be inserted into one's privates for close to a month.

"The vaginal ring is a do it yourself device inserted on the cervix and it slowly releases the drug into the cervix and around the vagina, which interrupts the HIV life cycle.

"The method has proved to be safe in studies done in other countries and we will run it in the country starting 2012 and for the next two years," she said

Dr Mgodi also said the trial is targeting women aged between 18 and 30 years because they are more vulnerable to HIV.

"Our prime target is married women as they fail to negotiate safe sex in their homes. Young women are also affected because of poverty so there are at high risk and those who are in unfaithful relationships," she said.

The project will be implemented simultaneously in Zimbabwe and other sub Saharan countries including Zambia, Uganda and South Africa.

If found to be safe, the vaginal ring will complement other preventive measures already available such as male circumcision, condom use and the Prevention of Mother To Child Transmission (PMTCT).

The UZ-UCSF is also doing other researches under the Vaginal and Oral Interventions to Control the Epidemic commonly referred to as the VOICE study.

One arm of the study, involving the use of oral Tenofovier tablets was stopped prematurely because it failed to prove that it can protect women from acquiring HIV.

"There is no concern about the safety of Tenofovir gel or the oral Truvada tablet either.

In fact, we are continuing to test them in the VOICE in hopes that we will find that they are effective," said UZ-UCSF principal investigator Professor Mike Chirenje.

Tenofovir and Truvada are anti-retroviral drugs that prevent HIV from replicating inside cells. They were tested in thousands of HIV - infected individuals and are approved as HIV treatment by a number of regulatory agencies.

As a result, the drugs are now used in a tablet form, in combination with other anti-retrovirals, to treat HIV in many countries including Zimbabwe. Statistics show that women account for approximately 60 percent of people living with HIV in sub Saharan Africa.

The peak for HIV infection in women is between the ages of 20 and 29 whilst for man it is between 30 and 39 years.

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