Vienna, Austria (July, 20, 2010) - The Global Forum on MSM & HIV (MSMGF) stands with HIV advocates around the world in congratulating scientists at the Center for the AIDS Programme of Research in South Africa (CAPRISA) on their new groundbreaking CAPRISA 004 trial results. CAPRISA 004 is an efficacy and safety trial that tested a1% tenofovir gel to prevent HIV transmission. Major findings included a 39 percent lower infection rate in those who used the gel compared to those who did not. Conducted in HIV-negative South African women, this was the first-ever trial to evaluate the efficacy of an antiretroviral-based microbicide; it is great cause for optimism regarding biomedical prevention approaches.
ARV-based HIV prevention entails, among other approaches, the use of microbicides as vaginal or rectal gels to reduce the chances of HIV transmission during sexual intercourse. We celebrate CAPRISA 004’s positive results as an important development for women’s advocates, who have highlighted the urgency of developing products that give women increased control over their own sexual health. The study is significant for the health of men who have sex with men (MSM) as well, with a growing global movement advocating microbicides research for rectal use.
It is important to note that CAPRISA 004 is a proof-of-concept study and that no microbicide, ARV-based or not, has yet been proven to effectively halt HIV transmission. The results and implications of the CAPRISA 004 trial must be confirmed through further research. In addition to efficacy trials, studies must be conducted to assess feasibility for potential roll-out and scale-up among different regional contexts and populations, including MSM.
Microbicides have the potential to become a formidable weapon in the fight against HIV among vulnerable populations. The CAPRISA 004 study focused solely on vaginal microbicides. More rectal microbicide research is needed in order to better understand their potential health benefits for MSM. Additionally, the complex and diverse challenges that MSM face around the world in regard to access, stigma, and criminalization have shown us that no one prevention technology can be a silver bullet.
Microbicides must therefore be understood as but one evolving part of an integrated prevention spectrum that employs a comprehensive range of already available, evidence-based approaches, from condoms and lubricants through structural interventions.
In order to ensure that such emerging HIV prevention technologies meet their full potential for reducing new infections, new science must be paired with strong advocacy. Each global region is different and requires a culturally competent and nuanced approach, but the need for action remains universal. We applaud these scientists for their efforts to enhance the tools at our disposal; it is now everyone’s responsibility to ensure that these tools are developed and released into a world that can use them.
While more exciting progress on ARV-based interventions is anticipated in the future, we must continue to stress the importance of a comprehensive and balanced approach in the fight against HIV – one that emphasizes targeted rights-based primary prevention strategies for communities that are especially vulnerable to HIV infection combined with treatment and support services for all people living with HIV.