Magazine article Population Briefs

Developing Microbicides to Combat HIV Transmission

Magazine article Population Briefs

Developing Microbicides to Combat HIV Transmission

Article excerpt

The Landscape

In the 1980s, at the beginning of the HIV epidemic, AIDS was thought to be primarily a "gay male" disease, and many people wrongly believed that women were not at risk. But just ten years later, the number of infections among women was as high as that among men in sub-Saharan Africa, where HIV was predominantly transmitted through heterosexual sex.

Prevention efforts at the time focused on abstinence or monogamy, treatment for sexually transmitted infections (STIs), and condom use. But for many women, social, cultural, and economic inequalities severely limited their ability to protect themselves from infection.

The Paradigm Shift

Recognizing the prevention challenges women faced, the international community began calling for a woman-controlled HIV prevention method that would provide protection without partner negotiation. At the time, published scientific research described the need for and the biology behind microbicides, female-initiated methods for reducing male-to-female transmission of HIV during sexual intercourse. But beyond the lab, none took a far-reaching look at the possible challenges of developing an acceptable, accessible, effective, and safe microbicide.

In 1992, the Population Council co-organized one of the first international symposiums on microbicides, bringing together women's health advocates, scientists, and program planners to explore the complexities of microbicide development from conceptualization to market. The outcome of that meeting was a seminal paper written by Council researcher Christopher J. Elias and Lori Heise of the Center for Women's Global Leadership, which pulled together current knowledge about the need for microbicides and scrutinized challenges--including issues regarding basic biology, clinical trials, and programs--for future microbicides development. …

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