With women being the largest group of HIV infected people in the world, a new treatment that could help them avoid transmitting the virus is causing excitement. A vaginal gel that can be self-applied may help reduce the numbers of infections.

With over 60 percent of new infections being women, and over 50 percent of the estimated 34 million people living with HIV or AIDS, women are the target of new efforts to curb the infection.

The Gel

The new treatment gel contains the anti-retroviral drug tenofovir. Infected women squirt the gel into themselves using a special applicator. This happens twice, 12 hours before sex, and 12 hours after.

The gel has also been found to reduce the incidences of herpes simplex 2, which is another virulent infection that causes problems on its own merits, but also makes it easier for HIV to gain a foothold in a person.

It works by lining the walls of the vagina, and penetrating the cells underneath, allowing the antiviral to get to work. This method is proving very effective in the trials so far.

The Trial

The Center for the AIDS Program of Research in South Africa (CAPRISA) has been running the trial in conjunction with the University of KwaZulu-Natal in Durban, South Africa. Funding was secured from the US Agency for International Development and the South African government for the trial.

There have been 11 such trials since 2004, with 6 other gels being tested. This latest one is the only one to have provided tangible improvements in infection rates.

Of almost 900 women in the test, 445 of them receiving the active gel, all were 39 percent less likely to become infected with HIV. The 444 using a placebo gel weren’t so lucky.Among women who used the gel exactly as instructed, the infection rate fell by 54 percent, suggesting that rates could be halved if women use it properly.

The use of antiviral drugs has been used to reduce the spread of HIV for a while now, in fact, it coincides with another study by the World Health Organization, in association with the United States National Institutes of Health. This study used antiviral drugs administered early to reduce the spread of the HIV virus.

Why it Works

This gel worked where others have failed thanks to the antiviral ingredient tenofovir. The other gels were simply being tested as a physical barrier to infection. Including the antiviral in the gel has helped produce the results we have today. The new gel penetrates and protects from within the cells that HIV normally infects.

With other treatments being researched, and some positive findings being fed into the media, it paints a picture of a gradual improvement in the treatment of HIV and AIDS. This gel is so exciting because it can be made available to the poorest countries, who usually have the highest rates of infection.

As long as the gel is used correctly, it can provide an effective barrier to many people. When used in conjunction with common sense, and other preventive measures, it could dent the spread of the disease across the world.

The Effect

If the gel works as the research suggests, it could reduce the number of infections significantly. By closing another door to the virus, we are gradually reducing its ability to transfer to another person. If used alongside other treatment methods, it could provide an impermeable barrier to entry.

With women being the most common carriers of HIV, it makes sense to develop a treatment that not only protects, them, but others too. Used in conjunction with condoms, this treatment could be very effective in reducing the spread of the virus.

If only one-third of South African women used the gel, it could prevent 1.3 million infections and 820,000 deaths over 20 years. Multiply that across the world, and we have a real sign of hope for the future.

The other significant effect is that of power. There is little a woman can do to protect herself from infection right now. Much is in the hands of the man. Giving a woman the tools to protect herself brings her destiny back into her own hands.

The Future

Another trial of the gel is planned for the near future, with the help of the United Nations Program on HIV/AIDS. The aim of the trial is to confirm the results of the first one, and to refine the gel to see if it can become even more effective.

Once confirmed, the process can begin to make the gel available across the world. Gilead, the California-based company which developed tenofovir, has granted the South African government permission to make the drug and to sell it in the gel without having to pay the company a royalty. That is a significant barrier removed, and the cost to produced reduced significantly.

Licensing for individual markets takes time, sometimes up to 2 years, so the gel won’t be available for a few years yet.

Alternatives

At the same time, Australian firm Starpharma are trialing a different vaginal gel called VivaGel, which uses a different antiviral, but is said to produce similar results.

This gel is based on dendrimers and has demonstrated effective inhibition of HIV and HSV-2 even 24 hours after application. If either of these gel treatments are successful, it provides a significant inroad to preventing the spread of HIV.

VivaGel is still undergoing clinical trials, but it promises to be a huge factor in the fight against the spread of HIV, and could cut the HIV infection rate even more than current treatments available on the open market.

Add a comprehensive education campaign to the release of either of these gels, and make them widely available and we have a possible reduction in infections across the board. It’s unlikely that these two gels are the only ones undergoing trials or development.

Once the formulas are made available, and companies like Gilead are generous enough to waive their royalties, we have a viable, effective treatment for the spread of HIV.