World AIDS Day: A New Tactic in the Fight Against HIV/AIDs

December 1, 2014

When HIV/AIDs began mysteriously killing gay men over three decades ago, few people could have foreseen that this disease would eventually cause the death of close to 34 million people by the 21st century.  While not nearly as rapidly lethal as Ebola, nor as contagious, HIV/AIDs has steadily decreased the human population, despite incredible advances by the scientific community, and despite heroic work by advocates around the world. 

Nor would anyone have guessed that HIV would end up infecting women in far greater numbers than men, particularly young women in sub-Saharan Africa and African American women in major cities like Washington, DC.   Biology has a lot to do with this, but so do poverty and a lack of education.  While condoms are highly effective at preventing infection, how many women in the U.S. have heard a new partner protest, “condoms are my kryptonite.”  A woman who doesn’t have to depend on a man for her next meal can remind him that he’s no Superman and force the issue, but not so in the developing world where uneducated, poor women can’t refuse their husbands or force their partners to wear condoms.    

Enter the MPT – multipurpose technology – a device or product designed to prevent sexually transmitted infections as well as pregnancy.  CONRAD recently launched a USAID-funded safety and acceptability trial of a vaginal ring containing tenofovir, an antiretroviral drug that has been shown to reduce the likelihood of HIV and herpes infections, plus levonorgestrel, a safe and effective contraceptive already approved for use in other forms (pills, IUDs, etc).  The two drugs are combined in one thin, flexible ring engineered to be effective for up to three months.  Another trial soon to be launched will test a recently approved one-size-fits most diaphragm with tenofovir gel – together, they have the promise of multipurpose protection.  Other organizations like Population Council and FHI360 also have promising leads, and funders like USAID and the Bill & Melinda Gates Foundation are putting some real muscle behind developing this new technology.

Why MPTs and how are they going to have an impact in reducing HIV infections? One school of thought is that the prospect of a nine month pregnancy followed by 18-plus years of support is more tangible than an unseen virus. High-risk, young women may be more motivated to use a method of HIV prevention that has the added bonus of contraception, or vice-versa.  Husbands or partners do not feel the ring during sex, and may fully support the idea of contraception and not take offense that HIV prevention is part of the package.  

On this World AIDS day, we want to shine the light on new technologies, like MPTs that are in development and testing and that can one day have an impact on what is still an epidemic.  Few of us are untouched by the tragedy of HIV/AIDs - whether we knew or know someone with HIV or perhaps admired an entertainer who died of AIDS (how many of our mothers or grandmothers adored Liberace and Rock Hudson) or just care deeply about the human race.  And few can deny that improved family planning is the best option when it comes to preventing unwanted pregnancies.  Combine both kinds of protection in one product and we have the potential to truly make the world a better place.  And that’s something to celebrate on World AIDS day! 

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