The Herald (Harare)

Zimbabwe: Why Research On New HIV Prevention Technologies?

ONE would wonder why at a time when financing for HIV and Aids is decreasing such that governments are failing to provide treatment to all in need, others continue to channel millions into trials for new prevention technologies.

Others have argued that the world already has preventive interventions that have been proved to work and the billions earmarked for these new interventions for prevention should, for now, be channelled towards scaling up already existing strategies for effective response to the HIV and Aids pandemic.

Statistics from the National Aids Council show that Zimbabwe has 1,2 million people living with HIV and Aids with a prevalence rate of 14,26 percent.

About 60 percent of these are women.

About 347 000 people are on life-prolonging anti-retroviral drugs (ARVs) against a total of 593 168 with CD4 count level of 350 who are in urgent need of treatment.

In terms of funding for treatment, Government says the gap continues to widen in line with set targets. This year alone, Government will need about US$9,1 million to provide treatment to 66 532 people in dire need of ARVs. Some strategies that have already been proved to work include the male and female condom, which is between 94 and 97 percent effective.

Male circumcision and the Prevention of Mother to Child Transmission (PMTCT) have also been proved to prevent HIV transmission by 60 and 50 percent respectively.

Other interventions known to work effectively in combating HIV are behavioural change and blood screening.

Scientists are currently working on trials in different parts of the world, Zimbabwe included, to establish if they could find another strategy that can effectively reduce HIV acquisition, especially among women.

"As things are, HIV infection is skewed towards women, who have little prevention methods available for them. We need to stop new infections in women now," Mrs Abigail Kangwende, director at the African University Clinical Research Centre (AUCRC), said.

Mrs Kangwende said the only option available for women now was the condom, which was difficult to negotiate for its use with their male partners.

"We all know that it is difficult for women to negotiate for safer sex with their partners. If a man does not want to use protection, the woman cannot force use of protection, hence the need for new technologies for women," Mrs Kangwende said.

Microbicides are among new technologies scientists are trying to prove that they can reduce HIV transmission in women.

They come in gels, films, or suppositories that can kill or neutralise viruses and bacteria.

Various trials are taking place in Zimbabwe, South Africa, Zambia and Uganda, among other African countries.

According to figures on the Global Campaign for Microbicides website, in 2010, global investment in microbicide research and development was approximately US$247 million.

Addressing delegates attending the just ended International Microbicides Conference during a plenary session held in Sydney, Australia, Global Fund to Fight Aids, Tuberculosis and Malaria deputy executive director Dr Debrework Zewdie said the ferocious speed of HIV infection warranted proactive responses.

"Because of the ferocious speed with which the HIV and Aids epidemic has spread, we as an international community must expand our prevention options more urgently than ever," Dr Zewdie said.

She said microbicides fill an important prevention gap in women.

However, she said there was not yet an effective microbicide today, two decades after trials began, because they were not given priority they deserved.

"We must ensure that any new prevention technology is universally available and accessible to the most marginalised and to people facing the highest risk," she said.

She said development of a more effective microbicide for use in combination with existing technologies will be valuable and most needed to the prevention tool- box.

  • Comment (4)

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Comments Post a comment

  • Hugh7
    Apr 25 2012, 19:36

    In Zimbabwe in 2005, USAID found 14.2% of non-circumcised men had HIV compared to 16.6% of circumcised men. (Similar differencess apply in 10 of 18 countries for which it has figures.) Shouldn't this at least be explained before blundering on with mass circumcision programmes? Clearly what seemed to work in clinical trials does not necessarily work in the real world. One reason could be here: http://tinyurl.com/7deqtap The experimenters did not correct nearly well enough for non-sexual transmission, especially through contaminated surgical instruments.

    The much-touted "60% HIV reduction" figure only applies to female-to-male transmission - if any. A study in Uganda started to find that circumcising men INcreases the risk to women (who are already at greater risk), but they stopped the study for no good reason before that could be confirmed.

  • Human Rights Abuse
    Apr 26 2012, 13:49

    About half the new HIV infections in africa are through NON-SEXUAL TRANSMISSION, (eg. unsafe skin-piercing cosmetic and medical procedures, and contaminated blood exposures, including intravenous drug use).

    http://www.circumcision.org/hiv.htm

    Circumcision can only worsen the HIV epidemic because:

    1) Some men may become HIV infected from the circumcision procedure itself when surgical instruments, syringes etc are used on multiple patients, but inadequately sterilized.

    2) At least 25% of men engage in sexual intercourse before their circumcision wounds have healed (half as early as 3 weeks).

    http://www.aidsmap.com/Quarter-of-men-resume-sex-before-wounds-from-circumc ision-fully-healed-in-Zambian-study/page/2227154/

    3) Many circumcised men mistakenly think that they have a "natural condom" so they believe they are "immune to HIV infection" and can be promiscuous with impunity. How wrong they are!

  • Human Rights Abuse
    Apr 26 2012, 13:28

    Just as female circumcision (genital mutilation) is a despicable atrocity intended to permanently reduce the sexual sensation of women, so too, male circumcision is nothing but penile-sexual reduction surgery (genital mutilation) intended to permanently reduce the sexual sensation/function of men. Circumcision under false pretences (ie. without FULLY INFORMED consent) is a human rights’ violation.

    http://www.cirp.org/library/sex_function/

  • Human Rights Abuse
    Apr 26 2012, 13:39

    About half the new HIV infections in africa are through NON-SEXUAL TRANSMISSION, (eg. unsafe skin-piercing cosmetic and medical procedures, and contaminated blood exposures, including intravenous drug use).

    http://www.circumcision.org/hiv.htm

    Circumcision can only worsen the HIV epidemic because:

    1) Some men may become HIV infected from the circumcision procedure itself when surgical instruments, syringes etc are used on multiple patients, but inadequately sterilized.

    2) At least 25% of men engage in sexual intercourse before their circumcision wounds have healed (half as early as 3 weeks).

    http://www.aidsmap.com/Quarter-of-men-resume-sex-before-wounds-from-circumc ision-fully-healed-in-Zambian-study/page/2227154/

    3) Many circumcised men mistakenly think that they have a "natural condom" so they believe they are "immune to HIV infection" and can be promiscuous with impunity. How wrong they are!