NIAID Director Fauci Discusses Effect of HIV/AIDS on Women, Microbicide Research

Anthony Fauci, director of NIH's National Institute of Allergy and Infectious Diseases, in a statement released on Saturday in recognition of International Women's Day discussed microbicide research and the effects of HIV/AIDS on women, CQ HealthBeat reports. Fauci in the statement said that in the U.S., the percentage of adults and adolescents living with HIV/AIDS who are female increased from 7% in 1985 to 27% in 2005. From 2001 to 2005, racial and ethnic minorities represented the vast majority of new HIV/AIDS cases among U.S. women, Fauci said, adding that black and Hispanic women accounted for 83% of those cases. For every 10 adult men living with HIV in sub-Saharan Africa, about 14 women are living with the virus, he said. According to Fauci, the majority of women living with HIV/AIDS worldwide became infected through heterosexual intercourse, usually in settings where they could not say no or negotiate condom use. "These issues compel us to develop HIV prevention tools that women can use in situations when negotiating with sexual partners is difficult or impossible," Fauci said (Reichard, CQ HealthBeat, 3/12). According to Fauci, a "critical avenue of research" in the development of HIV prevention tools for women is "safe, effective and acceptable topical microbicides" -- including gels, foams and creams that could be applied prior to sexual intercourse to prevent the sexual transmission of HIV and other sexually transmitted infections. He added that the development of microbicides "is a top HIV/AIDS research priority for NIH" (Fauci statement, 3/10). NIH is funding large clinical trials of two microbicides in Africa and the U.S., Fauci said. In addition, the agency will fund the Microbicide Trials Network, an international affiliation of clinical trials, CQ HealthBeat reports. Microbicide research experienced a setback earlier this year when Arlington, Va.-based Conrad announced that it halted Phase III trials of the microbicide Ushercell, also known as cellulose sulfate, in Africa and India. Jeff Spieler, head of reproductive research at USAID, said that he hopes "one or more of the other microbicide candidates will prove to be safe and effective." In a recent statement, Mitchell Warren, director of the AIDS Vaccine Advocacy Coalition, said that "getting a negative result for one product certainly doesn't signal failure for the microbicide field or broader biomedical HIV prevention research effort as a whole." Fauci in an interview on Monday said that it is "tough to tell" how the Conrad announcement affects the outlook for microbicide research. He added, "We're still cautiously optimistic." According to Fauci, a study conducted several years ago that examined the chemical agent nonoxynol-9 found that inflammation of the vagina might have overridden the protective effects of the agent because vaginal inflammation increases the risk of HIV transmission. NIH plans to test microbicides that include antiretroviral drugs to increase the protective effective even if vaginal inflammation occurs, Fauci said. Women have difficulty getting access to health care and therefore are diagnosed at later stages of HIV/AIDS than men, Fauci said, adding, "Therefore, we need to expand and support educational and employment opportunities for women and girls to address the harmful effects of inequality" (CQ HealthBeat, 3/12).