Gel and circumcision: New anti-HIV tools for women and men (Feature)

By Albert Otti Jul 21, 2010, 3:06 GMT

Vienna - Vaginal gels and male circumcision are creating excitement among scientists and campaigners working on HIV prevention, not only because they work, but because they help men and women take responsibility for their health.

While both tools do not offer full protection against the virus, they have the additional value of connecting clients to health services and to educate them about safer sex.

The results of a successful trial of the tenofovir gel in South Africa were presented at the 18th International AIDS conference in Vienna this week.

The trial showed for the first time that a drug normally used by HIV-positive people to fight the virus also works to prevent infections when it is applied locally before and after having sex.

The gel is one of several so-called microbicides being developed that could give women a tool to actively protect themselves, independent of whether their partner is faithful or uses a condom.

And unlike female or male condoms, the gel allows women to get pregnant.

'This product gives them something versus nothing,' said Quarraisha Abdool Karim, one of the lead scientists on the trial that was conducted by South Africa's CAPRISA research institution.

The gel, which is still several years away from coming on the market, lowered the risk of infection by 39 per cent.

Studies on circumcision in Kenya, South Africa and Uganda showed that men can reduces their risk of infection up to 60 per cent if they have their foreskin removed.

Circumcision programmes are being implemented with the help of UN organizations in thirteen countries in Southern and Eastern Africa, the world region most affected by HIV/AIDS.

The king of the Zulu nation in South Africa, Goodwill Zwelithini, announced in December that he wanted to revive the practice, in order to fight HIV.

Despite the promising gel trial and evidence that circumcision removes tissue that is susceptible to infection, scientists at the conference warned women and men not to rely on these measures alone.

'I would like to emphasize that it is not a natural condom,' World Health Organization expert David Okello said about circumcision.

The African circumcision programmes and the gel trial involve not just providing procedures and medication, but also intensive counselling on condom use, HIV testing, and on the risks of having multiple sexual partners in parallel.

In both studies on circumcision and the gel, participants did not start engaging in riskier sexual behaviour, scientists said.

Despite the optimism on these two tools, work still needs to be done to improve national health care systems to properly carry out circumcision programmes.

And the organizations involved with the vaginal gel said additional research was still needed before their product could go on the market. There is also work on patches and vaginal rings that protect women over a longer period.

Unlike other medications that are too expensive for people in developing countries, the tenofovir gel is set to be sold at affordable prices, because the rights to the drug is held by two US-based non-profit health groups.