Hope as women test HIV gel
South Africa could produce an antiretroviral vaginal gel to offer women protection from HIV infection, if the current trial of the Tenofovir product is successful.
The Follow-on African Consortium for Tenofovir Studies (FACTS) trial, which is testing the use of antiretroviral vaginal gel on 2900 local women, will be discussed at the South African Aids conference in Durban ,which started yesterday.
The women, from across the country, are being asked to use the gel 12 hours or less before, and again after, sex.
Professor Helen Rees, from the Wits Reproductive Health and HIV Institute and protocol chairman of the study, said what was exciting was that the FACTS trial was building on previous studies and, if successful, would be one of the last steps between research and the gel being registered as medication.
An effective vaginal gel would be good news for women who cannot always negotiate condom use with their sexual partners.
The study, funded by the Bill and Melinda Gates Foundation, USAid and the Department of Science and Technology, is taking place at nine sites across South Africa.
Rees praised the department for investing millions in the study which ends next year. In order for the study to be successful, researchers need to ensure that participants use the gel. But this may not be as simple as it seems.
In 2010 a study by the Centre for the Aids Programme of Research in South Africa showed that the women who used the antiretroviral gel 80% of the time or more had 54% protection from the virus.
But another gel study was a failure. The VOICE trial, an American run and funded effort, asked more than 2000 women in South Africa, Zimbabwe and Uganda to use Tenofovir gel or a placebo daily.
The trial was stopped a year early in 2011 because the women were not using the gel. Less than 30% of the participants used the gel they were supposed to use daily.
Researchers hope the current trial will be successful as the gel is only used before and after sex.
"Rather than every day, they need to use it around the time they have sex and are at risk. We hope this will make it easier for women to incorporate it into their lives," said Deborah Baron, programme manager at the Wits Reproductive Health and HIV Institute.
"Unless we can persuade women to use the product in the trial, there will be no gel product for women," said Rees.
About 5000 doctors, activists and researchers are attending the week-long Durban conference.