Selected writings

HIV Prevention: towards the medicalisation of sex?

2010 will be a year to remember for the field of HIV prevention. After decades of interventions with limited results (with the exception of circumcision and the prevention of mother to child HIV transmission), two clinical studies are raising the hope that the HIV epidemic can be tamed.

In July, the CAPRISA team (based in South Africa) reported that a vaginal gel containing the anti HIV drug tenofovir could reduce the risk of HIV infection by 39%. This was the first proof of concept that a microbicide could potentially reduce the risk of HIV infection whilst offering women an HIV prevention tool that they could control.

In November of the same year, the iPrEx study conducted on a population at high-risk of infection showed that taking the anti HIV Drug Truvada reduced the risk of contracting the virus by an average of 44 percent.

Both studies are hailed as a milestone and landmark in the history of HIV prevention and expectations are high that HIV prevention will finally mean more than the ABC of ‘Abstinence, condom and faithfulness’. But despite the hope, neither approach will immediately translate into marketable products as there are a number of questions that needs answering before microbicide and PrEP are available to the public. (more…)

By Roger, ago
Selected writings

A funding struggle for an HIV prevention in women’s hands

Attendees at the 18th International AIDS conference held in Vienna in July 2010 felt a tremor of hope when Prof. Salim Abdool Karim received a standing ovation following the announcement that a vaginal gel containing the anti-HIV drug tenofovir could reduce the risk of HIV infection by 39%. The groundbreaking results came out of the CAPRISA clinical trial conducted amongst 900 women in rural Vulindela district (KwaZulu-Natal) and urban Durban, South Africa. Euphoria followed in the audience, online and later in the printed media. After 30 years of limited success, the field of HIV prevention could potentially add a new powerful tool to circumcision, condoms, and the prevention of mother to child transmission. Most remarkably, that tool is in women’s hands and the story could unfold with even more good news if it weren't for a small setback: funding the next clinical studies. (more…)

By Roger, ago
Concept maps

The road to HIV infection

Being infected with HIV is not just a question of having unsafe sex with someone who is HIV+. Such reductionist approach ignores the complex set of factors, circumstances and events that lead to unsafe sex to take place. This concept map tries to survey these factors starting from the remote Read more…

By Roger, ago
Concept maps

ARV for HIV prevention, an overview

Despite the interesting results of an HIV vaccine trial in Thailand (RV144), HIV prevention is still limited to a small number of options many of which are not bullet-proof. Biomedical interventions based on vaccines and microbicides are still a long shot away. Conversely, treatment is working well in bringing HIV-infected Read more…

By Roger, ago
Concept maps

Microbicides for HIV Prevention

Microbicides are compounds that can be applied inside the vagina or rectum to protect against sexually transmitted infections (STIs) including HIV. They can be formulated as gels, creams, films, or suppositories. Microbicides may or may not have spermicidal activity (contraceptive effect). At present, an effective microbicide is not available (WHO Read more…

By Roger, ago
Concept maps

PrEP, An Overview

Pre-exposure prophylaxis (PrEP) is an experimental HIV-prevention strategy that proposes using antiretrovirals (ARVs) to reduce the risk of HIV infection in healthy uninfected people at risk of acquiring the virus. PrEP is not proven to work and is currently being tested in HIV-negative people in several clinical trials across the Read more…

By Roger, ago