Goodbye Condoms, Hello Gel

Robin Maguire doesn't shy away from putting her hand literally in the goo.
"I was, in a way, responsible for my own baby," Maguire said in a recent interview as she dabbed a glob of an odorless, colorless substance made from carrageenan into her hand.
Maguire, a biomedical researcher for the Population Council and co-chairwoman of the biannual global conference on microbicides in South Africa next month, considers the substance her “baby” because she is largely responsible for giving it new commercial life.
Carrageenan has been used for years in toothpaste, ice cream, shampoo and champagne, but Maguire found that it also could be used to produce substances that can prevent sexually transmitted diseases in women when applied vaginally within 48 hours of exposure.
These substances, known as microbicides, represent a potential breakthrough in contraception and the prevention of sexually transmitted diseases.
The biggest breakthrough, some say, since the condom or the pill.
“I believe the future belongs to microbicides," said John Fidi, founder of Condom Depot, an online condom store. "I come from the school of progressive thought and believe that condoms will most likely be obsolete down the road when a safe microbicide is developed."
Current trial microbicides come inside tubelike applicators designed to help a woman apply them internally. They are most effective when applied within 24 hours of sexual activity.
Microbicide research is important because HIV rates are rising in women.
Women account for 27 percent of the cases of HIV infection in America, up from 7 percent 20 years ago, according to recent remarks by Dr. Anthony S. Fauci, director of the National Institute of Allergy and Infectious Diseases at the National Institute of Health. Worldwide, there are 17.5 million women (46 percent of the total adult cases) with HIV, an increase of almost 1 million infections since 2003.
Rep. Christopher Shays, R-Conn., has introduced legislation in Congress that would increase financing for microbicide research.
"In many settings, the typical woman who gets infected with HIV has had only one partner, her husband," Shays said. "Microbicides would allow these women to protect themselves against the spread of disease.”
Social workers and health care professionals say microbicides will give women greater control over their sexual health, because the pill does not prevent sexually transmitted diseases and some women cannot count on their male partners to always wear a condom.
Even when men are given a choice of condoms, including those designed to enhance their sexual pleasure, they don't necessarily use them, according to a study by Family Health International, a nonprofit group that is researching microbicides.
The study also found that a microbicide used regularly gives a woman more protection than a traditional product like a condom that is used infrequently. A separate study by Dr. Kenneth H. Mayer of Brown University released last month found that 94 percent of women are ready to "definitely" or "probably" use the gel if it were available.
But micobicides may still be years away from commercial availability. One reason is that researchers and doctors are still unsure how HIV spreads in women.
"Not enough is known about the earliest moments of HIV's interaction with the human body," said Dr. Rowena Johnson, director of research at the American Foundation for AIDS Research.
"The more we know,” she said, “the better equipped we will be to develop a broader range of inventions--drug treatments used before or shortly after exposure to the virus, a microbicide or even a vaccine--to break the link in the chain of events leading from HIV transmission to established infection."
Another reason is lack of research financing.
Only 2 cents of every dollar spent by pharmaceutical companies go to microbicide development, and that could make it difficult to place microbicides on the commercial market even by 2010, according to American Foundation for Aids.
But Maguire and others remain hopeful that a commercial product can be developed sooner, perhaps in the next year or two.
Results from the third and final trial of the gel, called Carraguard, are due in April 2007, and it will take about two months to produce the finished product if the tests, being conducted in South Africa, go well.
Maguire said that means Carraguard could be registered as a drug either in the United States or in South Africa next year.
"We are blazing the trail in an unknown field," Maguire said.
from INS News