The seventh (and last?) International Microbicides Conference: from discovery to delivery
Skye McGregor A , Gilda Tachedjian B C D F , Bridget G. Haire E and John M. Kaldor A
+ Author Affiliations
- Author Affiliations
A The Kirby Institute, The University of New South Wales, Sydney, NSW 2052, Australia.
B Burnet Institute, Burnet Institute, Centre for Virology, 85 Commercial Road, Melbourne, Vic. 3004, Australia.
C Department of Microbiology, Monash University, Clayton, Vic. 3800, Australia.
D Department of Infectious Diseases, Monash University, Melbourne, Vic. 3004, Australia.
E Centre for Values, Ethics and the Law in Medicine, University of Sydney, Sydney, NSW 2006, Australia.
F Corresponding author. Email: gildat@burnet.edu.au
Sexual Health 10(3) 240-245 https://doi.org/10.1071/SH12211
Submitted: 17 December 2012 Accepted: 16 January 2013 Published: 24 May 2013
Abstract
The most recent estimates indicate that in 2011, 34 million people were living with HIV, the majority in sub-Saharan Africa. Even though the estimated number of new infections is decreasing, there remains an urgent need for new prevention technologies, particularly those controlled by women and men who have receptive sex. Microbicides are products designed to be applied vaginally or rectally to prevent acquisition of HIV and other sexually transmissible infections and, as such, provide a great hope for female-controlled HIV prevention. Oral prevention drugs are a more recent development that also has great potential. The field changed radically in 2010–2011 with the first trials demonstrating effectiveness of a microbicide and oral prevention drugs. The seventh biannual Microbicides conference, which took place in Sydney, Australia, in April 2012, was the first conference in this series since these new results and represented a transition from the discovery phase of research to considerations of implementation. Researchers, advocates, community representatives, funders and the media came together over 3 days to talk about the realities of implementation, particularly in regard to challenges in adherence and funding, and also examined early findings for new prevention technologies. This report of the 2012 International Microbicides Conference provides a summary of recent developments and ongoing challenges in the field of microbicides research.
Additional keywords: female-controlled prevention, HIV, oral prevention drugs, pre-exposure prophylaxis.
References
[1] UNAIDS. World AIDS Day report 2012. Geneva: UNAIDS; 2012.[2] Celum C. State of the evidence from efficacy trials: What we know and what we still need to know. 2012 International Microbicides Conference, 15–18 April, Sydney, Australia. Sydney: Australasian Society for HIV Medicine; 2012.
[3] Heneine W. Tenofovir gel in the monkey model and other PK findings on the impact of menstrual cycle on vaginal drug absorption and bidirectional dosing. 2012 International Microbicides Conference, 15–18 April, Sydney, Australia. Sydney: Australasian Society for HIV Medicine; 2012.
[4] Abdool Karim S. CAPRISA 004 two years on: what were the lessons, what are the implications? 2012 International Microbicides Conference, 15–18 April, Sydney, Australia. Sydney: Australasian Society for HIV Medicine; 2012.
[5] Herold B. The biology of HIV transmission: implications for the design of effective PrEP. 2012 International Microbicides Conference, 15–18 April, Sydney, Australia. Sydney: Australasian Society for HIV Medicine; 2012.
[6] Herold B. Antiviral activity in cervicovaginal lavage (CVL) as a biomarker of the potential efficacy of topical and oral pre-exposure prophylaxis (PrEP): results from the MTN 001. 2012 International Microbicides Conference, 15–18 April, Sydney, Australia. Sydney: Australasian Society for HIV Medicine; 2012.
[7] Marrazzo J. The vaginal microbiome and BV (clinical/diagnosis/biofilms). 2012 International Microbicides Conference, 15–18 April, Sydney, Australia. Sydney: Australasian Society for HIV Medicine; 2012.
[8] Landay A. HIV, BV and the innate immune response. 2012 International Microbicides Conference, 15–18 April, Sydney, Australia. Sydney: Australasian Society for HIV Medicine; 2012.
[9] O’Hanlon DE, Tachedjian G, Moench TR, Cone R. When lactobacilli dominate (Nugent score 0–3) they inactivate HIV and BV bacteria with lactic acid. 2012 International Microbicides Conference, 15–18 April, Sydney, Australia. Sydney: Australasian Society for HIV Medicine; 2012.
[10] Ravel J, Gajer P, Fu L, Koenig S, Sakamoto J, Motsinger-Reif A. et al. Effects of HIV vaginal microbicides on the vaginal microbiota as determined by pyrosequencing of 16S rRNA genes. 2012 International Microbicides Conference, 15–18 April, Sydney, Australia. Sydney: Australasian Society for HIV Medicine; 2012.
[11] Rees H. HIV and contraception. 2012 International Microbicides Conference, 15–18 April, Sydney, Australia. Sydney: Australasian Society for HIV Medicine; 2012.
[12] Romano J. The barriers and incentives in the pathway to developing a usable new technology for HIV prevention. 2012 International Microbicides Conference, 15–18 April, Sydney, Australia. Sydney: Australasian Society for HIV Medicine; 2012.
[13] Stewart K, Young Holt B, Romano J, Harrison P, Turpin J, Kerrigan M, et al. Multipurpose prevention technologies (MPTs) for sexual and reproductive health: integrating basic and behavioral science throughout the critical path. 2012 International Microbicides Conference, 15–18 April, Sydney, Australia. Sydney: Australasian Society for HIV Medicine; 2012.
[14] Murphy DA, De Wit JBF, Holt M, Callander D, Ellard J, Rosengarten M, et al. Only a minority of sex is planned among gay men in Australia: findings from the PrEPARE project. 2012 International Microbicides Conference, 15–18 April, Sydney, Australia. Sydney: Australasian Society for HIV Medicine; 2012.
[15] Lees S, Sufiani A, Celestine V, Hilali E, Kiro K, and the MDP trial team. Microbicides: addressing Tanzanian women’s broader concerns with sexuality. 2012 International Microbicides Conference, 15–18 April, Sydney, Australia. Sydney: Australasian Society for HIV Medicine; 2012.
[16] Gafos M. ‘The things we do for love’: love medicines and microbicides in a predominantly rural area of KwaZulu-Natal, South Africa. 2012 International Microbicides Conference, 15–18 April, Sydney, Australia. Sydney: Australasian Society for HIV Medicine; 2012.
[17] Kanyemba B. Contextualising pre-exposure prophylaxis for the realities of HIV prevention and care in South Africa: outcomes from a community-based advocacy project. 2012 International Microbicides Conference, 15–18 April, Sydney, Australia. Sydney: Australasian Society for HIV Medicine; 2012.
[18] Forbes A. Status report: where are we on development of new tools relevant to women with HIV? Non-ARV based microbicides. 2012 International Microbicides Conference, 15–18 April, Sydney, Australia. Sydney: Australasian Society for HIV Medicine; 2012.
[19] Patten S. Status report: where are we on the development of new tools relevant to women with HIV? Therapeutic vaccines. 2012 International Microbicides Conference, 15–18 April, Sydney, Australia. Sydney: Australasian Society for HIV Medicine; 2012.
[20] Bruning J. Female condom. 2012 International Microbicides Conference, 15–18 April, Sydney, Australia. Sydney: Australasian Society for HIV Medicine; 2012.
[21] Ghati L. Advocacy and structural issues overall. 2012 International Microbicides Conference, 15–18 April, Sydney, Australia. Sydney: Australasian Society for HIV Medicine; 2012.
[22] McGowan I. Rectal microbicides development – where have we been and where are we going? 2012 International Microbicides Conference, 15–18 April, Sydney, Australia. Sydney: Australasian Society for HIV Medicine; 2012.
[23] Audu K. Rectal microbicide advocacy in Africa. 2012 International Microbicides Conference, 15–18 April, Sydney, Australia. Sydney: Australasian Society for HIV Medicine; 2012.
[24] Pickett J. Around the world with IRMA – global rectal microbicide advocacy priorities, opportunities and challenges. 2012 International Microbicides Conference, 15–18 April, Sydney, Australia. Sydney: Australasian Society for HIV Medicine; 2012.
[25] Hankins C. Standard of prevention in the UNAIDS/WHO guidelines. 2012 International Microbicides Conference, 15–18 April, Sydney, Australia. Sydney: Australasian Society for HIV Medicine; 2012.
[26] Macklin R. Ethical principles for addressing post-trial access to new HIV prevention options for women. 2012 International Microbicides Conference, 15–18 April, Sydney, Australia. Sydney: Australasian Society for HIV Medicine; 2012.
[27] Sugarman J. Ethical obligations and aspirations regarding prevention and care in HIV prevention research. International Microbicides Conference, 15–18 April, Sydney, Australia. Sydney: Australasian Society for HIV Medicine; 2012.
[28] Ukpong M. A community advocate’s perspective on the standard of care issue. 2012 International Microbicides Conference, 15–18 April, Sydney, Australia. Sydney: Australasian Society for HIV Medicine; 2012.
[29] Corneli A. Motivators of adherence in clinical trials. 2012 International Microbicides Conference, 15–18 April, Sydney, Australia. Sydney: Australasian Society for HIV Medicine; 2012.
[30] Taylor D. Asking about and measuring adherence. 2012 International Microbicides Conference, 15–18 April, Sydney, Australia. Sydney: Australasian Society for HIV Medicine; 2012.
[31] Hayes R. The future of HIV prevention trials in HIV. 2012 International Microbicides Conference, 15–18 April, Sydney, Australia. Sydney: Australasian Society for HIV Medicine; 2012.
[32] Moench TR, O’Hanlon DE, Cone R. MEMS monitoring and UV inspection of applicators as a quantitative assessment of adherence. 2012 International Microbicides Conference, 15–18 April, Sydney, Australia. Sydney: Australasian Society for HIV Medicine; 2012.
[33] Van Der Straten A. Self reports, electronic monitoring and biomarkers: how best to integrate these tools to explain adherence? 2012 International Microbicides Conference, 15–18 April, Sydney, Australia. Sydney: Australasian Society for HIV Medicine; 2012.
[34] McGowan I, Hoesley M, Cranston R, Andrews P, Janocko L, Dai J, et al. MTN:007 a Phase 1 randomised, double blind, placebo controlled rectal safety and acceptability study of tenofovir 1% gel. 2012 International Microbicides Conference, 15–18 April, Sydney, Australia. Sydney: Australasian Society for HIV Medicine; 2012.
[35] Richardson-Harman N, Elliott J, Janocko L, Cumberland W, Zhou Y, McCormick T, et al. Dose–response relationship between rectal tissue levels of rectally-applied UC781 microbicide gel and reduction of ex vivo HIV infectibility of biopsies from in vivo exposed rectal tissue from the Phase 1 trial RMP-01. 2012 International Microbicides Conference, 15–18 April, Sydney, Australia. Sydney: Australasian Society for HIV Medicine; 2012.
[36] Crook A, McCormack S, Nunn A. Designing microbicide trials without a placebo. 2012 International Microbicides Conference, 15–18 April, Sydney, Australia. Sydney: Australasian Society for HIV Medicine; 2012.
[37] Zewdie D. Who pays? Global resourcing for new HIV prevention technology. 2012 International Microbicides Conference, 15–18 April, Sydney, Australia. Sydney: Australasian Society for HIV Medicine; 2012.
[38] Katana M. Making access a reality for all those in need. 2012 International Microbicides Conference, 15–18 April, Sydney, Australia. Sydney: Australasian Society for HIV Medicine; 2012.
[39] Baeten J, Celum C. Oral antiretroviral chemoprophylaxis: current status. Current opinion in HIV and AIDS 2012; 7 514–19.
| Oral antiretroviral chemoprophylaxis: current status.Crossref | GoogleScholarGoogle Scholar | 1:CAS:528:DC%2BC3sXis1Wlsrk%3D&md5=b98c9b7610b52085af0a333150ec2ac4CAS | 22964886PubMed |
[40] Cohen MS, Chen YQ, McCauley M, Gamble T, Hosseinipour MC, Kumarasamy N, et al Prevention of HIV-1 infection with early antiretroviral therapy. N Engl J Med 2011; 365 493–505.
| Prevention of HIV-1 infection with early antiretroviral therapy.Crossref | GoogleScholarGoogle Scholar | 1:CAS:528:DC%2BC3MXhtVars7jF&md5=560e3d74f02174a6ddec3749d67d5bf8CAS | 21767103PubMed |
[41] Abdool Karim Q, Abdool Karim SS, Frohlich JA, Grobler AC, Baxter C, Mansoor LE, et al Effectiveness and safety of tenofovir gel, an antiretroviral microbicide, for the prevention of HIV infection in women. Science 2010; 329 1168–74.
| Effectiveness and safety of tenofovir gel, an antiretroviral microbicide, for the prevention of HIV infection in women.Crossref | GoogleScholarGoogle Scholar | 1:CAS:528:DC%2BC3cXhtV2hsr%2FI&md5=edf775f75d124742a563d00fadc0976bCAS | 20643915PubMed |
