On Tuesday, the International Microbicides Conference (http://www.microbicides2010.org/) (M2010) came to a close in Pittsburgh. It was the sixth biennial meeting focused on HIV prevention and microbicides—topical products being developed to prevent HIV, and convened almost 1,000 researchers, clinicians, policymakers and advocates from around the world.
This year, the conference’s theme was “Building Bridges in HIV Prevention,” and the program included a broader range of topics than ever before, including vaginal and rectal microbicides and pre-exposure prophylaxis (PrEP) — the use of low doses of antiretroviral drugs (ARVs) by HIV-negative people to prevent infection. Some of the major highlights were:
v On the first day of the conference, researchers presented findings (http://microbicides2010.org/files/pregnancy%20release_no%20embargo.pdf) showing that not only are women more susceptible to HIV infection during pregnancy, but men are also at increased risk of acquiring HIV if their HIV-infected partner is pregnant. This has significant implications because many couples choose not to use condoms during pregnancy.
v On day two of the conference, researchers highlighted promising new microbicide formulations (http://microbicides2010.org/files/more%20than%20gel%20_NO%20EMBARGO.pdf), such as long-lasting vaginal rings, easy-to-use vaginal films, and dissolvable tablets. One study (http://microbicides2010.org/file/more%20than%20gel%20Loxley%20abstract.pdf) showed that a vaginal ring could deliver a combination of two anti-AIDS drugs, dapivirine and maraviroc, at therapeutic levels for up to 30 days.
v Also on day two, the results of two studies (http://microbicides2010.org/files/ARVs%20briefing%20release%20NO%20embargo.pdf) were announced showing that ARV-based prevention can actually increase the risks of drug resistance if used by patients who are unknowingly infected. The results should not diminish the promise of PrEP and other ARV-based HIV prevention approaches, researchers said, but rather highlight the importance of incorporating HIV testing and monitoring of infection status in prevention programs involving ARVs.
v The final day of the conference featured new findings (http://microbicides2010.org/files/lubricants%20briefings%20release%20No%20emb...) showing that some lubricants may increase the risk of HIV transmission for receptive male and female partners engaged in anal sex.
There are an estimated 33 million people around the world living with HIV—a number that is still growing. Faced with these numbers, HIV prevention research is more critical than ever. As M2010 comes to a close, the world finds itself a few steps closer to the goal of a safe and effective method to prevent HIV infection.
I'd invite conference attendees to continue their conversations from the event here, and welcome others to ask follow up questions. I'm interested in particular as to what research has been done around how these prevention tools interact with existing ones (for example, condom usage, reduction of concurrent partnerships, etc.) and what implementation strategies will look like as breakthroughs in development are made. If we're unable to move these into the field quickly, but with a fairly robust idea of their implications for overall HIV prevention efforts, we'll run into an unfortunate (and seemingly avoidable) bottleneck.