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AIDS Factsheet

Preventing HIV Infection

Microbicides

WHAT ARE MICROBICIDES?

AIDS FACT-SHEET

Background Information
-What is AIDS?
-HIV Testing
-Acute HIV Infection
-How HIV Drugs Get Approved
-HIV Life Cycle

Laboratory Tests
-Normal Laboratory Values
-Complete Blood Count (CBC)
-Chemistry Panel
-Blood Sugar and Fats
-CD4 (T-cell) Tests
-Viral Load Tests
-HIV Resistance Testing
-Monitoring Drug Levels

Preventing HIV Infection
-Stopping the Spread of HIV
-How Risky Is It?
-Condoms
-Drug Use and HIV
-Harm Reduction and HIV
-Treatment After Microbicides
-Microbicides

Living with HIV
-Choosing an HIV Care Provider
-Medical Appointments
-Telling Others You are HIV Positive
-Participating in a Clinical Trial
-How to Spot HIV/AIDS Fraud
-Vaccinations and HIV
-Medications to Fight HIV

-HIV Life Cycle
-Taking Current Antiretroviral Drugs
-What Is Antiretroviral Therapy (ART)?
-Adherence
-Treatment Interruptions
-Drug Interactions
-Strengthening the Immune System

-Immune Therapies in Development
-Immune Restoration
-Interleukin-2
-Immune Restoration Syndrome
-Opportunistic Infections

-Opportunistic Infections

Side Effects and Their Treatments
-Side Effects
-Fatigue
-Anemia
-Body Shape Changes (Lipodystrophy)
-Diarrhea
-Peripheral Neuropathy
-Mitochondrial Toxicity
-Bone Problems
-Depression and HIV

Patient Populations

-Women and HIV
-Pregnancy and HIV aids
-Children and HIV
-Older People and HIV

Alternative and Complementary Therapies
-Alternative and Complementary Therapies
-Ayurvedic Medicine
-Chinese Acupuncture
-Chinese Herbalism
-Cat's Claw
-DHEA
-DNCB (Dinitrochlorobenzene)
-Echinacea
-Essiac
-Marijuana
-Silymarin (Milk Thistle)

-Nutrition
-Nutrition
-Vitamins and Minerals
-Exercise and HIV
-Smoking and HIV

Microbicides are anti-HIV substances. They could reduce the risk of HIV infection during vaginal or rectal intercourse. No microbicides are available yet. However, with sufficient funding and demand, microbicides could be available by 2010.

They could be a very important part of global HIV prevention efforts. Currently, male and female condoms are the only tools we have for HIV prevention. However, many men object to wearing condoms. Many women do not feel they can demand, or even ask their male partners to use a condom. Currently, over 50% of new HIV infections worldwide occur in women.

The use of microbicides could be controlled by women. They could be applied before sex. They won�t require male cooperation to use, the way male and female condoms do. Some might be products women can use without their partners� knowledge.

They will come in gels, foams, and creams. Some may take the form of a sponge or thin film that can be inserted with the fingers. Rings or diaphragms may also be inserted into the vagina to deliver microbicides. Microbicides can also be put in suppositories, small plugs of medication designed to melt at body temperature when placed in the vagina or rectum.

One study estimated that microbicide use could prevent about 2.5 million HIV infections within 3 years. This is based on a microbicide that only worked 60% of the time and was used by only 20% of women, in 73 low income countries. Microbicides may also protect women against some other sexually transmitted diseases, in addition to HIV.

Condoms are still the most effective method of preventing infection. Ideally, microbicides would be used along with condoms for added protection. But, for people whose partners won�t use condoms, microbicides could offer a way of reducing HIV risk that can be used without a partner�s participation.

MICROBICIDES AND VACCINES
Vaccines against HIV have gotten much more attention than microbicides in recent years. An effective vaccine would offer important advantages:

It could be given to a large segment of the population at risk
It would be effective for several years
It would not depend on people remembering to use it

Microbicides, on the other hand, depend on people remembering to use them correctly each time they have sex. Once developed, microbicides and vaccines would work together. Microbicides will put the power of prevention directly in women's hands.

After a period of optimism about the development of an HIV vaccine, research has slowed. The virus presents several obstacles to vaccine development. At this point it is not clear when a vaccine might become available. However, it is unlikely to be within the next 10 years.

Microbicide research is further along. But microbicide research has also encountered setbacks. Nonoxynol-9 (N-9) is a spermicide that was tested as a microbicide. Research showed that frequent use of N-9 may actually increase the risk of HIV infection. It can damage the lining of the vagina or rectum, making it easier for HIV to get past the body�s defenses. N-9 had to be discarded from the list of potential microbicides.

HOW DO MICROBICIDES WORK?
Microbicides could work in various ways:

They could immobilize the virus
They could create a barrier between the virus and the cells of the vagina or rectum to block infection
They could prevent HIV from reproducing and establishing an infection after it has entered the body

Some potential microbicides work in just one of the ways above and some combine two or more methods, to increase effectiveness.

HOW MANY MICROBICIDES ARE NEAR APPROVAL?
No anti-HIV microbicides are currently approved as safe and effective. However, many are being tested. These tests are going on around the world. Large-scale tests are going on mainly in Africa where the HIV rates are highest.

Four microbicides are in Phase III (final) testing. The microbicides closest to approval are Carraguard, cellulose sulfate gel, PRO 2000 Gel, BufferGel and Savvy. Cellulose sulfate gel is also being studied as a contraceptive.

THE BOTTOM LINE
Microbicides are anti-HIV substances designed in various forms to provide additional protection against HIV. They are intended to be used as an additional prevention measure or in cases where a partner is not using condoms.

Dozens of potential microbicides are in various stages of research. Once available, they could help women and men protect themselves. Microbicides may be especially important for women in developing nations who are not always empowered to require partners to wear condoms.

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AIDS Factsheet

Preventing HIV Infection

Microbicides