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They can take the form of a gel, cream, film, suppository or sponge that contain an active ingredient which can kill or inactivate HIV cells. "Once developed, microbicides could revolutionise women's lives by becoming an extremely important HIV prevention measure," says Dr Kim Dickson of the World Health Organisation (WHO) in Geneva. According to Dr Dickson, many women do not have the social power to negotiate condom use with older men, including their husbands. "The ABC of prevention (Abstinence, Being faithful, and using Condoms) does not work for many women. Many cannot abstain from sex, they may be forced or just cannot say no to partners. Others are faithful but their partners, including husbands and steady partners, are not. "Women are looking for a safe, easy to use, effective and affordable method to protect themselves against HIV. Microbicides could be the answer. Unlike condoms, they can be used by women without the consent or knowledge of their sexual partners," says Dr Dickson. Six clinical efficacy trials for microbicides are currently being conducted in Africa, India and the United States - four of which are underway in South Africa. The largest trial involves 11,920 women in South Africa (Durban and Johannesburg), Uganda and Tanzania. The other trials involve 6,639 women in South Africa (Durban, Cape Town and Pretoria); 3,220 women in South Africa (Durban and Hlabisa in KwaZulu/Natal), Zimbabwe, Zambia and Malawi; 2,574 women in South Africa (Durban), Benin, Burkino Faso, India, Kenya and Uganda; and 2,142 women in Nigeria and Ghana. Although the African studies are focusing on HIV prevention in women, studies in the United States are also evaluating microbicides as an HIV prevention method for men who have sex with men (MSM). Latest updates on these research studies will be presented next month at an international conference in Cape Town, co-chaired by Dr Kim Dickson (WHO), Prof Gita Ramjee (Medical Research Council), and Prof Helen Rees (Reproductive Health and HIV Research Unit, Wits University). "Microbicides 2006" is the first conference of its kind in Africa, and takes place at the Cape Town International Convention Centre, from 23 to 26 April 2006. Previous conferences were hosted in Washington in 2000, Antwerp in 2002, and London in 2004.
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