New focus on HIV prevention
The Microsoft boss said the harsh mathematics of the epidemic meant that ‘treatment without prevention is simply unsustainable’.
Male circumcision, vaginal micobicide barrier gels, cervical barriers, preventative anti-retrovirals and herpes suppression are all prevention approaches in the late stages of clinical research.
These may provide a welcome supplement to the rather tired prevention ABC of ‘Abstain, Be Faithful and Condomise’.
The close to 24 000 delegates attended many sessions dealing with science based prevention methods that are in clinical trials, mostly in Africa.
Although a vaccine is the most highly anticipated weapon to stop AIDS, it is at best 10 years or longer away.
In the interim, trials of vaginal barrier gels called microbicides are showing the most promise and very importantly put prevention in the hands of women.
The first results from these trials are expected towards the end of next year.
The other prevention hope is pre-exposure prophylaxis (PREP), an ARV pill that can be taken orally to prevent transmission.
Health minister Dr Manto Tshabalala-Msimang told Health-e News Service that there was an urgent need to accelerate prevention. She confirmed that she had been briefed on the male circumcision study from Orange Farm which showed that circumcised men were 60% less likely to get HIV than uncircumised men, but that she was waiting for results from Uganda and Kenya before making a policy decision.
Asked for her opinion on PREP, the minister said she had ‘come here to listen, not to set policy’.
Dr Gita Ramjee of the Medical Research Council, one of two South Africans who spoke at the one of the main conference sessions, said that ‘2007 and 2008 are going to be very good years for prevention’.
Other trials and scientific investigations were being done into microbicides containing antiretrovirals, vaginal rings, cervical barriers such as the diaphragm, and herpes suppression using acyclovir.
Herpes, which infects up to 70 percent of people in some parts of sub-Saharan Africa, can triple the risk of people getting HIV as well as increase their chances of passing it on to others.
But even if these measures work, much work needs to be done to get them to the people who need them most. The United Nations Population Fund warned that millions of people still lacked access to the most basic and available preventive method of all ‘ the male and female condom.
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