‘Chemical condom’ to curb HIV under trial

Not a victory. A truce.

Hildreth leads the Centre for AIDS Health Disparities Research at Meharry Medical College, where he is developing a cream that could potentially block the transmission of HIV during sex.

The cream could give hope to millions of women in Africa who have no way of protecting themselves from HIV transmission, as well as black women in the United States who are disproportionately affected by the disease.

The vaginal cream, described as a ”chemical condom”, relies on a sugar found in toothpaste and mouthwash to remove cholesterol the HIV virus needs to spread. The cream is odourless and is designed to be undetectable to a woman’s sexual partner.

”In many parts of the world, women are not in the position to negotiate how sex is practiced,” including the use of condoms, Hildreth said. ”We have been trying to formulate something transparent to the act of having sex. Women might be able to use it without getting permission or even letting the men know they are using it.”

Earlier this summer, Hildreth travelled to Lusaka, Zambia, to see how women and men reacted to the feel and the smell of the cream. About 1.1 million Zambians, 17 percent of the adult population, were living with HIV in 2005, according to the United Nations. Researchers expected men to reject the cream, but most accepted it.

”Even among the most rural of Africans now, the word is starting to get out about what a serious and expansive problem the AIDS pandemic is,” Hildreth said. ”There’s a certain desperation that people feel for something to protect themselves.”

Meharry received a US$10 million grant from the National Institutes of Health in 2003 to fund AIDS research in a new facility that opened in April this year. There, in a secure lab, Hildreth and six researchers work with potent strains of HIV.

The research is particularly important to Meharry, one of only four historically black medical institutions in the country, given the disproportionate effect of AIDS on the black US population. Although African-Americans make up 13 percent of the US population, they account for 50 percent of AIDS cases in the country.

Reasons for the disparity vary. Poverty and lack of access to health care are often given as underlying causes, but Meharry researchers are also looking at genetic predispositions that might make blacks more susceptible to contracting the virus and the severity of its symptoms.

They are particularly concerned about black women, who were diagnosed with AIDS at a rate 23 times higher than that of white women in 2005, according to the Centres for Disease Control and Prevention.

”African-American women are shouldering the brunt of HIV in the United States, and it has significant implications for the stability of the black family,” said Dr Wayne Riley, Meharry president and CEO.

Hildreth’s cream has already proven effective with monkeys and mice, and he hopes to receive approval from the Food and Drug Administration this autumn to begin the first trials on people early next year.

Hildreth readily acknowledges that there is a chance that the cream, also known as a microbicide, could fail. Last year, the final trials of a microbicide were halted after tests showed women who used the gel were actually contracting HIV at a higher rate than those using a placebo.

If Hildreth’s cream works, it could become one of several drugs used to combat HIV prevention. But Hildreth is not seeking to totally stop the disease. He’s just trying to find a way to slow it down.

”At the end of the day, this microbicide may not work,” Hildreth said. ”All the evidence is to the contrary, that it will work, but we do experiments and medical trials to get the answers. I do think that just the process of doing it well and trying to be excellent in what we do will make a difference.

“We think there’s layers and layers of significance in what we’re doing, and we’re very proud to be doing it.” ‘ The Tennessean/Gannett News Service.

August 2008
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