Treatment Holds New Promise In War on HIV: Microbicide gel could empower most at risk - married women

Microbicides can substantially reduce transmission of sexually transmitted infections when applied either in the vagina or rectum, and the cautious optimism over their development was a rare positive note on the last full day of the International Aids conference yesterday. The meeting in Bangkok has been dominated by disappointment at the slow progress in introducing drugs to save lives in poor countries while the numbers of those becoming infected and dying continue to soar, says the news report.

Women in sub-Saharan Africa are increasingly being infected by the virus because they are often powerless to negotiate sex with their husbands. More married women are becoming infected than unmarried women, because their husbands are unfaithful and will not use condoms. A weapon against HIV/Aids designed for women is urgently needed, Zeda Rosenberg, the chief executive of the International Partnership for Microbicides, told the conference yesterday. 

"Twenty-five percent of women in South Africa are infected with HIV by the time they are 22 years old," Dr Rosenberg said. "In studies from Kenya and Zambia, adolescents who are married are contracting HIV at a faster rate than sexually active unmarried teenagers. And unfortunately parts of Asia are not far behind. So for women worldwide, being young and married are the most significant risk factors for acquiring HIV infection."

Rosenberg predicted that a microbicide would be available in five to seven years. Even if it had limited efficacy - perhaps as low as 30% - it would save huge numbers of lives, she said. With vaccine research results disappointing, the microbicide looks likely to be the best bet for prevention in the near future.  

The Economist further reports that of the most contentious issues in the field of AIDS is the use of condoms. Some people—including many on America's religious right—object to them because they think that contraceptives of any sort encourage promiscuity. Others—the pope and couples who want to have children—object simply because they are contraceptives. Others again object because condoms detract from the pleasure of sexual intercourse. The last two objections, though, would be rendered irrelevant if a different barrier to the entry of HIV could be found. 

The next few years could see the discovery of just such a barrier, for one of the most promising ideas being discussed at the AIDS conference in Bangkok was that of vaginal microbicides.  Microbicides have many advantages. They would be controlled by women, and controlled in such a way that a man would not necessarily have to know that one was being used. And, depending on which particular type of microbicide was being used, they need not have a contraceptive effect. That means that if only one individual in a partnership was infected, the couple would be able to have children without risking an infection in the other, says the news report.

In a story on the World Bank’s Multi-Country AIDS program for Africa (MAP), the Correspondent reports that Keith Hansen, Manager of the World Bank’s AIDS Campaign Team for Africa, said that MAP funds are aimed at catalyzing efforts of grassroots organizations that are fighting HIV/AIDS. “All that grassroots organizations have to do to access MAP funds is to show us that they can use the money and that their responses reflect a national strategy grown out of a national authority and ownership.”

Hansen indicated that half of the $1 billion from the MAP will be spent by civil society. Already 25 community-based organizations have accessed the money. “This money is meant to catalyze small community-based initiatives that exhibit best practices,” Hansen said. “Community organizations are given liberty to decide on what to use the resources for.”

Finally, the Associated Press reports that when historians reflect on the global battle against the HIV epidemic, one possible bright spot could be women's empowerment in the developing world, specialists say.The accelerating feminization of the HIV pandemic is gaining ever wider recognition as public health experts chart the global response. Many experts say that women's rights will need to be an important element of the fight if the world is to succeed in the long-term. While just under half of the 38 million people infected worldwide are women, 75 percent of infected young people between 15 and 24 are women and girls in sub-Saharan Africa. In many other areas where the AIDS disaster is at an earlier stage, infected women increasingly outnumber men. While AIDS has certainly raised the level of discussion about women's emancipation in the developing world, it remains to be seen whether humanity's worst scourge can be a powerful enough motivator to change women's lives in poor countries.

Experts at the conference said there have been pockets of progress in some countries, with more education for girls, more opportunities to work outside the home, loan programs aimed at helping women set up businesses, and legislation designed to protect them from violence. If anything, AIDS is likely to have a role in women's rights of women by providing them with tools to protect themselves from HIV infection, such as HIV-killing vaginal gels, or microbicides, and similar products that give women control over whether they get infected, says the news report.