In a groundbreaking study, a gel made using an antiretroviral drug was found to be effective in reducing a woman's risk of becoming infected with HIV. This is the first time in history that this kind of topical medication, known as a microbicide, has worked, despite many earlier trials. The research broke yesterday at the International AIDS Conference in Vienna and is widely believed to be the biggest news that will come out of the 6-day event.
Though the results will need to be confirmed and a product won't hit the market for at least a few years, this news marks a major stride for women around the world, particularly in Africa and in African American communities. It will finally offer a female-controlled way for women to protect themselves in the sexual arena where men, too often, call all the shots.
"This becomes a self empowerment resource for Black women who are disproportionately impacted among all women with HIV," says C. Virginia Fields, president and CEO of the National Black Leadership Commission on AIDS. "This would provide a much-needed tool in our arsenal against HIV, given that there are so few effective interventions targeting women of color. Ideally it will stem the tide of increased infections."
The study of 889 uninfected Black women aged 18 to 40 in rural and urban KwaZulu-Natal, South Africa, found that the gel containing the HIV drug tenofovir (currently prescribed in pill form under the trade name Viread) cut infections by 39 percent. Among the women who used it consistently and correctly, the results were even better: 54 percent effectiveness. Either way you look at it, in the science world these numbers signal a major coup.
The researchers also noted that genital herpes risk dropped by 51 percent, which was a surprise. Actually, said epidemiologist Salim S. Abdool Karim, Ph.D., who with his wife, Quarraisha, also an epidemiologist, led the study team, the results were a surprise. Seven of their previous trials over many years, he explained, had failed.
"When we sat down at the table to finally see the results, it hit us--this works--and we were stunned. In fact, we didn't say anything for a full minute," said Dr. Salim S. Abdool Karim, director of the Centre for the AIDS Programme of Research in South Africa (CAPRISA), located in Durban. Late last night, he and his wife spoke to a small delegation of Black journalists who had traveled to Vienna. The two researchers of color provided this exclusive access to assure that African-Americans got the full story the night before the couple presented their results to the full conference. When the scientists unveiled their findings at 1 p.m. Vienna time, thousands listened. Even the overflow room was full, as participants crowded around screens in the hall, applauding as Drs. Adbool Karim spoke.
This kind of breakthrough is urgently needed. In sub-Saharan Africa, where the epidemic is most dramatic and deadly, 22.4 million are living with HIV and every year millions more become newly infected. Women account for almost two-thirds of those living with HIV in the region, and young women, often poor and powerless, bear the brunt of the epidemic. South Africa, where the study took place, has more people living with HIV than any country in the world.
Dr. Quarraisha Abdool Karim explains that the research grew out of frustration at not being able to offer protection to women who would come into clinics where she worked in South Africa. "When they asked us what can we do to protect ourselves, we had nothing to offer them," she said. "Abstinence? They were married or in a stable relationships—no. Behavior change? They were faithful, but not sure about their partners' faithfulness. Condoms? Men don’t want to wear condoms, and at the time there was no female condom.
"So today, although we don’t have the microbicide," she continued, "the results signal hope for women that they will have something that is 39 percent more effective than nothing."