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August 2010, Week 5

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Sun, 29 Aug 2010 23:00:52 -0400
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Staying Negative: How An Unexpected Antiretroviral 
Result Is Reshaping The Battle Against AIDS
Success Of A Vaginal Microbicide Gel Reveals How
HIV-Prevention Strategies Can Emerge From Progress
In Treatment
By Lynne Peeples
Scientific American
August 25, 2010
http://www.scientificamerican.com/article.cfm?id=staying-negative

[moderator: to read this entire article
http://www.scientificamerican.com/article.cfm?id=staying-negative]

The promising preventive gel, which cut infection rates
among participating women in the South African province
of KwaZulu-Natal by 39 percent, contained 1 percent of
the antiretroviral (ARV) medication tenofovir, the same
drug commonly taken in pill form as part of a standard
HIV-treatment regimen. Its apparent safety and success
also bodes well for other up-and-coming ARV-based
prevention therapies such as pre-exposure prophylaxis
(PrEP).

"We need a dramatic increase in the prevention agenda to
get down to our goal of 1 to 1.5 million new global
infections every year," says Paul De Lay, deputy
executive director of the Joint United Nations Program
on HIV/AIDS (UNAIDS), adding that the pandemic's annual
global growth is currently stabilized at close to 3
million new infections. An estimated 22.4 million people
in Sub-Saharan Africa and 3.8 million people in South
and Southeast Asia currently live with the virus.

Meanwhile, the money being devoted to AIDS prevention
and treatment across the world has also flatlined,
forcing careful choices to ensure the "best value for
our money," he says. "We can't just treat our way out of
the problem. And we can't waste money on interventions
that may not be valuable."

The last two decades of strikeouts in microbicide
prevention studies could have put this particular
strategy into question. In fact, some of the gels tested
actually appeared to raise the risk of transmission. But
none of these earlier options contained any active ARV
drugs.

"It's been a long road, and there have been
disappointments," says Halima. "But we now know a lot
more about HIV. And we've been able to use that
technology not only to develop very effective treatment
strategies but also to help reduce the onward
transmission of HIV."

"Of course, getting from a p-value in a clinical trial
to a microbicide in the hands of a woman is another long
journey," she notes.

[moderator: to read this entire article
http://www.scientificamerican.com/article.cfm?id=staying-negative]

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