Research update

Female Condoms Only 0.2 percent of Total Global Condom Supply

Global

In “Saving Lives Now: Female Condoms and the Role of U.S. Foreign Aid”, a report issued on  April 22, the Center for Health and Gender Equity (CHANGE) points out that, while the U.S. has more than quadrupled international shipments of female condoms since 2004, female condoms still represent less than two percent of the total U.S. international condom procurement.

Serra Sipple, Executive Director of CHANGE, noted at the report launch that "The U.S. and other donors must increase comprehensive funding for the purchase, distribution and programming of female condoms to ensure that women and men have access to female condoms and know how to use them."  She added that nearly 26 million female condoms were distributed worldwide in 2007, compared to 11 billion male condoms. Despite their proven effectiveness and acceptability, female condoms account for just 0.2 percent of total global condom supply.

The Global Campaign’s goal has always been to amplify demand for more and better HIV prevention options, particularly for women  We are now increasing our efforts to mobilize advocacy for access to the female condom, especially in countries hardest hit by the HIV pandemic. Not only must the devices, themselves, be made readily accessible and affordable to women globally but introduction programs must also be instituted in many countries to provide the social marketing, provider education and effective distribution networks required to get female condoms into women’s hands. Bernice Heloo, President of the Society for Women and AIDS in Africa and a champion of female condom introduction in Ghana, noted on April 22 that, "Female condoms have not failed; we have failed to conclusively promote a device that not only protects African women's reproductive health, but also empowers them by giving them a tool that can remain in their hands for many generations to come."

As microbicide advocates, we support female condom promotion efforts both because women have an immediate right to more and better risk reduction tools and because strengthening female condom delivery now will help develop effective pathways for the successful introduction of microbicides in the future. 

“Saving Lives Now: Female Condoms and the Role of U.S. Foreign Aid” is available at http://www.preventionnow.net/ or directly at http://www.preventionnow.net/images/savinglivesnowfinal.pdf.

Late last month, the Microbicides Trials Network (MTN) and the Alliance for Microbicide Development hosted their annual meetings in Washington, DC.

Giving an overview of the Network’s scientific agenda and research priorities, the MTN meeting focused on several recent, on-going and planned trials of new antiretroviral (ARV)-based microbicides and other novel delivery approaches. Dr. Sharon Hillier, Co-Director of the Microbicides Trial Network, presented the results of the HPTN 059 study of safety and acceptability of 1% tenofovir gel as a topical vaginal microbicide in the United States and India. Notable among the findings was the high level of self-reported adherence among trial participants: 83% of trial participants reported daily use of the gel, although most missed at least one daily dose during the two-week follow-up period. Researchers were also able to detect small levels of tenofovir in the blood of 79% of women who reported gel use, suggesting that these self-reported adherence data were fairly accurate.  These data also highlight the need for further pharmacokinetic and drug resistance studies as tenofovir gel moves into larger safety and efficacy trials. Another interesting finding was that 12 participants in this trial reported social harms - usually arguments between participants and their partners about condom use - suggesting that future clinical studies need to monitor and mitigate some of the potential economic and social risks associated with trial participation.

Other MTN researchers presented on current or planned microbicide trials, including:

Ø       an overview of the VOICE (Vaginal and Oral Interventions to Control the Epidemic, also known as MTN003) – designed to evaluate the safety and effectiveness of an oral ARV versus a vaginal gel;

Ø       MTN 002 – the first ever study of the absorption and pharmacokinetics of vaginal tenofovir gel in late-stage pregnancy; and

Ø       MTN 007- a study of the safety of using a candidate vaginal microbicide rectally.

For more information about these and other MTN-sponsored studies, including downloadable PowerPoint presentations from the meeting, please visit http://www.mtnstopshiv.org/node/mtn_annual_meeting.

In contrast to the MTN meeting, the Alliance for Microbicide Development meeting focused on applying lessons from past microbicide studies to future pre-clinical and clinical trials. Dr. Polly Harrison, Director of the Alliance, opened the meeting by announcing the launch of the Alliance’s newly revamped website (http://www.microbicide.org), including its new content management system to allow users to search for microbicide-related publications more quickly and easy.

The two highlights of the meeting, were a panel discussion of the recently published Institute of Medicine (IOM) report examines the scientific and ethical challenges of designing and running large-scale clinical trials of microbicides, pre-exposure prophylaxis (PrEP), and other novel HIV prevention technologies; and John Kaldor’s and Betsy Harold’s presentations on pre-clinical and early clinical studies of microbicide safety and efficacy. Dr. Kaldor’s and Dr. Harold’s presentations, in particular, emphasized the need for the field to reflect more thoughtfully on the recent CS and Savvy trial closures, and the flat results from the MIRA and Carraguard studies.

Downloadable PowerPoint of the Alliance meeting presentations will be available on their website shortly at www.microbicide.org.

Highlighted Resources

Microbicides Glossary
Have you experienced trouble explaining some of those complicated microbicide terms or are you unsure of some of them yourself?  The Gender AIDS Forum (GAF) has published a “Glossary of terms used in microbicides research”.

This useful and handsome factsheet can be found at http://www.global-campaign.org/clientfiles/Glossary.pdf.

Also, be sure to visit GAF’s website (http://www.gaf.org.za/) to learn more about their work on gender and HIV/AIDS.

 

All of Us: A film about resilience, sisterhood & courage

All of Us, a feature length documentary by Pureland Pictures, provocatively reminds us – through the lens of women’s real experience – that love and sex can mean life or death.

 

In the South Bronx, a young doctor embarks on a research project to find out why black women are being infected with the HIV virus at an alarming rate. Dr. Mehret Mandefro takes us into the lives and relationships of two of her female patients, Chevelle and Tara, as they identify and struggle with the social factors that put them at risk.

 

As Chevelle and Tara strive for more power in their lives and relationships, Mehret expands her research to include women across boundaries of race, class and country. She also begins to grapple with these extremely personal themes as they begin to appear in her own life. A visit to Ethiopia, her birthplace, and candid conversations with her privileged girlfriends in New York

yield a startling realization: heterosexual women across the world, regardless of class or race, face a dangerous power imbalance in the bedroom. All of Us is about AIDS but it is not a tragedy. It is a story of resilience, sisterhood and courage. 

To view a trailer of the film, see a list of upcoming screening or purchase a copy of the film, please visit http://www.allofusthemovie.com/home.php.

Pureland Pictures is interested in advocacy opportunities. To discuss ways to incorporate All of Us into your outreach and activism, please contact Ssanyu Kalibbala at ssanyu@purelandpictures.com.

Parts of the above story, reprinted with the permission of Pureland Pictures.

Advocacy in action

Calling on UNGASS Delegates to Reaffirm Commitment to NPTs

Global

On 10 - 11 June 2008, a United Nations General Assembly Special Session on AIDS (UNGASS) Review Meeting on HIV/AIDS will be held in New York City, USA.  The first UNGASS in 2001 passed a Declaration of Commitment that has been described "as the single most important international policy instrument in the fight against AIDS".  In it, the endorsing countries agreed to time-bound commitments and a regular process for reviewing their progress toward meeting those commitments. Periodic UNGASS Review Meetings, such as the one upcoming in this June, are held as a part of this process. 

The 2001 UNGASS Declaration of Commitments on HIV/AIDS included a call for accelerated access to AIDS vaccines and microbicides (para 70). This commitment was reaffirmed in the 2006 UNGASS Declaration. In preparation for the 2008 UNGASS meeting, therefore, the Global Campaign has joined with the International Partnership for Microbicides, the AIDS Vaccine Advocacy Coalition, the National AIDS Trust (UK), and the International AIDS Vaccine Initiative in urging the United Nations member states and delegates attending that meeting to once again explicitly underscore their support for the development of new HIV prevention tools.  We are calling on them to articulate this support in their individual country statements and during remarks on UNGASS panels, roundtables and other discussions. A copy of our joint statement outlining the concrete forms this support should take is available on line at http://www.global-campaign.org/clientfiles/UNGASS08-Statement.pdf.

 

 

New Rectal Microbicides Network in Latin America and the Caribbean

Latin America
International Rectal Microbicide Advocates (IRMA) is very excited to share an important development for global rectal microbicides advocacy efforts. A new sister network has been created – IRMA-ALC (América Latina y El Caribe) – which will focus on rectal microbicide advocacy and research efforts in Latin America and the Caribbean.

 

IRMA-ALC has been formed by members in Peru, Ecuador and Brazil, who are co-chairs of the new network, including:

 

·         Jerome Galea from the UCLA Program in Global Health in Peru and IRMA Steering Committee member

·         Dr. Javier and Dr. Jorge Sánchez from Investigaciones médicas en salud (INMENSA), a health research institute in Peru

·         Beatrice Grinsztejn, Valdilea Veloso and José Henrique Pilotto from FIOCRUZ, a public health institute in Brazil

·         Orlando Monotya from EQUIDAD, a gay, lesbian, bisexual organization in Ecuador

 

“Although there is evidence of high frequency of anal sex among both men and women in Latin America, there is little interest in implementing clinical trials for rectal microbicides in the region”, according to IRMA-ALC co-chair Dr. Jorge Sánchez. “The Latin American chapter of IRMA will advocate for a critical look at various opportunities for rectal microbicides research and push for its development in the region. We also want to facilitate the process for integrating these HIV prevention research efforts at a regional level, while instigating South-South collaboration.” (original quote in Spanish)

IRMA-ALC has a logo and new page on the IRMA web site. They will disseminate information in Spanish, and perhaps eventually in Portuguese. There is now a Spanish-language listserv that members can join from the web site.