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Study shows gel cuts HIV infections

Cash also helps African women avoid virus

LOS ANGELES – For the first time in the bleak history of the AIDS epidemic on the African continent, researchers have identified two new approaches that could blunt the impact of HIV on women: a vaginal gel to block infection, and cash payments to delay sexual activity. Together, experts say, they might finally make headway against a disease that has killed millions.

The approaches, described in separate findings released Monday at the International AIDS Conference in Vienna, Austria, are considered especially important because women have borne the brunt of the epidemic. African men rarely use condoms or other methods that might prevent transmission of the virus, and their wives and partners are generally powerless to convince them to do so. Further, girls and young women are often forced into sexual activity because of their families’ abject poverty.

The more significant finding concerns the efficacy of a vaginal gel containing a microbicide. The gel could place prevention squarely in the hands of women; unlike with a condom, their partners would not have to consent to its use, and might not even know it is being used. A clinical trial of the gel showed that it could block more than half of new infections if used regularly.

In the other study, researchers found that they could delay sexual activity in girls and young women by supplementing family income with modest amounts of money, as little as a few dollars a month. That delay led to a 60 percent reduction in HIV infections.

The money appears to allow families more economic freedom, ultimately delaying girls’ sexual activity. Researchers hope such a delay will have a long-term impact on their overall health.

The results with the microbicide are particularly gratifying to scientists because more than 30 previous clinical trials of such agents have yielded little or no benefit.

“This is the first time we have seen any microbicide give a positive result,” said Anthony Fauci, director of the U.S. National Institute of Allergy and Infectious Diseases. “Given that women make up the majority of new HIV infections throughout the world, this finding is an important step toward empowering an at-risk population with a safe and effective HIV prevention tool.”

An estimated 33 million people worldwide are living with HIV, two-thirds of them in sub-Saharan Africa; another 32 million have died of AIDS complications.

Previous attempts at producing a microbicide have used detergents or other chemicals that don’t specifically target the AIDS virus. The new trial used the antiretroviral drug tenofovir, which is manufactured by Gilead Sciences Inc. of Foster City, Calif., and interferes with the replication of the virus.


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