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HIV Positive Women

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HIV-positive women are some of the most vocal advocates for microbicides as well as for expanded research on all aspects of HIV positive women’s reproductive health. By protecting health and promoting healthy sexuality, microbicides would offer an important and welcome tool in positive women's lives. Women living with HIV face the challenges of the epidemic daily, and offer a unique perspective on the broad impact microbicides could have in their lives.

Could Microbicides benefit women living with HIV?

Microbicides could help reduce a woman’s risk of infection with new strains of HIV and possibly her risk of infection with other sexually transmitted and vaginal infections that can pose serious health problems, especially when one’s immune system is weakened. Some of the candidate products being tested are broad spectrum microbicides that target a broad range of infections, not just HIV. If one of these is proven effective, it may help women reduce their risk of other sexually-transmitted infections (STI). Some may even promote vaginal health by warding off yeast infections or bacterial vaginosis.

Could Microbicides benefit the partners and families of HIV-positive women?

The microbicide trials currently underway are designed to answer the question of whether or not the test product works to help keep HIV negative people from becoming HIV positive. The next question will be whether it also works to help prevent transmission of HIV from a positive person to a negative person, and considerably more research will be required to determine that.  

Some of the candidate microbicides now in development may eventually  prove to be bi-directional – that is, capable of protecting HIV positive women’s sexual partners by disabling any HIV occurring in vaginal secretions, as well as semen. Such a product could give positive women a way to reduce their male partners’ risk of infection, even if he chooses not to use condoms.

Microbicides are not expected to be as protective as condoms – but they will be far more protective than nothing when used by people who aren’t using condoms.

Some of the candidate microbicides in development may also be contraceptive, while others may not. Since condoms prevent pregnancy, there is currently only one alternative available (alternative insemination ) to HIV positive women wishing to become pregnant but also wishing to fully protect an HIV negative partner.

All candidate microbicides must be safe for HIV-positive women
 

Women living with HIV are likely to have different needs for, and responses to, various microbicide products than HIV negative women. We must understand these factors before microbicides become widely available; both because positive women will be using them, and because many women may not know their HIV status before using a microbicide. Thus, candidate microbicides must go through early trials to assess their safety for HIV positive, as well as HIV negative, women. These preliminary safety trials must be followed by trials that generate long-term use data among women living with HIV so that researchers can adequately assess the long-term impact of such products. These early safety trials must be followed by more trials which generate data on the long-term use of microbicides by HIV positive women.

If an ARV-based microbicide is proven to be both safe and effective for HIV negative women, it may still not be appropriate for use by HIV-positive women. There is a chance that it could cause the development of drug resistant virus in her body, which might compromise her future treatment options. Scientists have not yet determined whether the small amount of ARV contained in these candidate products is likely to cause resistance but, if it does, this particular type of microbicide might only be appropriate for HIV negative women[1].


[1] For more information on this, see “Understanding HIV Drug Resistance” (fact sheet #HIVDrugResistance) and “ARV-Based Microbicides: The Promise and the Puzzle” (fact sheet #ARVBasedMCBs) posted on the Global Campaign for Microbicides website at www.global-campaign.org.