"Varginal gel cuts HIV infections by half" By RESEARCHERS.

A microbicidal vaginal gel
has significantly cut the rate
of women contracting HIV
from infected partners in an
experiment in South Africa.

The gel, containing the Aids
drug tenofovir, cut infection
rates by 50% after one year
of use, and by 39% after two
and a half years, researchers
said.
If the results are confirmed
it would be the first time
that a microbicidal gel has
been shown to be effective.
Such a gel could be a defence
for women whose partners
refuse to wear condoms.
New ways of curbing the
spread of HIV are badly
needed, particularly in sub-
Saharan Africa, where nearly
60% of those infected with
the virus are women.

Many women are often
forced to take part in unsafe
sex, and are biologically
more vulnerable to HIV
infection than men, making a
gel they apply an attractive
option.
Welcoming the results, UN
agencies said they would
convene an expert
consultation in South Africa
next month to discuss the
next steps with the product.
'Just pennies'
The results of the three-year
study, which was completed
by the Centre for the Aids
Programme of Research in
South Africa (Caprisa), are
being presented at an
international aids
conference in Vienna and
were published on Monday by
the US magazine Science.

The gel was found to be both
safe and acceptable when
used once in the 12 hours
before sex and once in the 12
hours after sex by women
aged 18 to 40 years.
Salim Abdool Karim, one of
the two leading co-
researchers, told reporters
in Vienna that the 889 women
involved in the trial,
conducted in the coastal city
of Durban and a remote rural
village, had largely used the
gel as directed.
They were also given
condoms and advice about
sexually transmitted
diseases, and tested for HIV
once a month.
After 30 months, 98 women
became infected with HIV -
38 in the group that got
tenofovir in the gel and 60 in
the group that got placebos.
"We showed a 39% lower
incidence of HIV in the
tenofovir group," Dr Karim
said.

Tenofovir, he added, lowered
the risk of infection by 50%
at 12 months but then the
efficacy declined.
Women who used the gel
more consistently were much
less likely to be infected, he
said.
He added that he did not
know how much each dose
would cost but said the
applicators and gel cost "just
pennies".
"Boy, have we been doing the
happy dance," Dr Karim, from
the University of KwaZulu-
Natal in Durban, said.
'Hope for women'
"It's the first time we've
ever seen any microbicide
give a positive result that
you could say was
statistically significant,"
said Dr Anthony Fauci,
director of the National
Institute of Allergy and
Infectious Diseases.

The researchers say women
who used the gel also showed
a significant reduction in
genital herpes, a common
sexually transmitted infection, which itself increases the risk of HIV infection. The UN's HIV/Aids agency noted that nearly 20 years of research had gone into microbicides that can be
controlled by a woman,
independent of her partner.
"We are giving hope to
women," said Mr Michel
Sidibe, executive director of
UNAids. "For the first time we have seen results for a woman-
initiated and controlled HIV
prevention option."
A microbicide, he said, would
be a "powerful option for the
prevention revolution and
help us break the trajectory
of the Aids epidemic".
Dr Margaret Chan, director-
general of the World Health
Organization, welcomed
Caprisa's findings.
"We look forward in seeing
these results confirmed," she
said.

"Once they have been shown
to be safe and effective,
WHO will work with
countries and partners to
accelerate access to these
products." Scientists say vaginal
gel cuts HIV-infections by half Women in the trial are said to have used the gel largely as directed Related stories Aids 'key cause of female death' African young 'change sex habits' Analysis An easy-to-use microbicidal gel proven to significantly reduce the risk of HIV
infection would be a very
important breakthrough in
the fight to control the
spread of HIV/Aids.

The best way to minimise the
risk of infection during sex is
to use a condom - but this is
not an option for many
women around the world who
find it difficult to insist that
a man take the necessary
precautions.

As a result, women have
become particularly
vulnerable to infection in
recent years and in Sub-
Saharan Africa, where the
Aids pandemic is most
severe, they make up nearly
60% of those who are
infected with the virus.
To compound the problem,
science has shown that
women are biologically more
at risk of infection than men.
An effective gel would
finally give women the
chance to do something to
protect themselves from
infection - to take control of
their own sexual health.
However, several earlier
trials have produced
disappointing results, and
even the results of the latest
trial - impressive though
they are - underline that a
gel is far from a fail-safe
form of protection.
But provided a gel could be
made widely accessible to
women in some of the
world's poorest countries,
where it is needed the most,
it could help to transform
many lives for the better.