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Women are at the epicenter of the HIV/AIDS epidemic, representing nearly half of the 33 million people worldwide currently infected with the virus. As mothers, caregivers and, increasingly, the population at highest risk of contracting HIV/AIDS, women face unique challenges in managing their own health and the health and well-being of their families.
IPM recognizes that women urgently need access to safe, effective and self-initiated HIV-prevention options at affordable prices. With dozens of agents that interrupt HIV infection identified and under study for use as microbicides, IPM believes that the accelerated development of a safe and effective microbicide product is achievable.
Sufficient investment from both the public and private sectors and a sustained commitment to moving the most promising products through well-designed clinical trials as quickly as possible could put a licensed microbicide product into the hands of the world’s women in the next five to seven years.
Microbicides are vaginal products being developed to reduce the transmission of HIV during sexual intercourse. Microbicides could take the form of a gel, film or sponge, or be contained in a vaginal ring that releases the active ingredient gradually. A microbicide could also be in a new formulation and use a delivery method yet to be invented. A microbicide would be a useful complement to other HIV prevention measures, including safer sex education, condom distribution, voluntary testing and counseling, testing and treatment of sexually transmitted infections, anti-stigma campaigns, safe blood supplies and (hopefully, one day) a vaccine.
Developed in the 1990s, the earliest microbicide products are expected to provide partial protection against HIV infection. First-generation microbicides include products that work by forming physical barriers to the virus and by changing the chemistry of a woman’s vagina to make infection less likely. These products are formulated into a gel to be applied vaginally just before sex and are therefore coitally dependent.
With consistent use, these products have the potential to avert millions of deaths. Currently, there are 2 first-generation microbicide products in large-scale efficacy trials throughout Africa and India.
Next-generation microbicides are IPM’s focus and several are currently in development by IPM, or with IPM’s support, such as Dapirivine, IPM’s lead candidate, and Tenofovir. Other next-generation microbicides in development include CONRAD’s UC781 and Samjin’s Pyrimidinediones. They have been developed based on the experience and lessons learned from the progress made with first-generation microbicides. Next-generation microbicides contain an antiretroviral product that is specific to HIV, unlike first-generations. These microbicides are being tested in a variety of intravaginal forms- gels, creams, rings, or films and can be applied once a day, or in case of the ring, once a month. Next-generation microbicides are coitally independent. The development of combination therapies which fight viral transmission on several fronts simultaneously represents the future of HIV prevention and also are a priority for IPM.
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