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More than 35 million people globally are living with HIV and over two-thirds of those infected reside in sub-Saharan Africa; and while rates of infection are decreasing in the US, they are still rising in South Africa. This is likely attributable to the fact that condom use has decreased in South Africa. As a result, young women in the nation are accounting for the majority of new HIV infections.

But why can’t these women just carry their own condoms? Condom negotiation is often a challenging task for women, especially those who lack agency due to socioeconomic factors.  It is, therefore, necessary to provide women in this region with the tools they need to take control of their sexual health.

CONRAD, a leader in reproductive health research, has developed a vaginal gel that women can use before and after sex that will reduce their risk of herpes and HIV. The topical gel contains 1% tenofovir, which is an antiretroviral drug that blocks the crucial reverse transcriptase enzyme in HIV-1. A series of clinical trials has proven the gel to be effective in reducing the risk of both HIV and herpes with proper use. Today’s reported results of the VOICE study show that the gel cuts down the risk of herpes infection (HSV-2) in half. The CAPRISA trial in 2010 showed a 39% decrease in HIV acquisition risk overall and a 54% decrease in women with high gel adherence.

So what are the next steps? CONRAD is working on additional tenofovir products for women, and the tenofovir gel is undergoing a Phase III clinical trial (called FACTS 001) which should be completed early next year. Hopefully, this product will soon be widely administered and live up to its name as the new game changer in HIV prevention worldwide.

“We can’t treat our way out of the epidemic,” says Abdool Karim, one of the lead researchers on the tenofovir gel. Prevention is necessary, and this gel will give control back to girls who cannot insist on condoms or faithfulness from their partners.

Think About:

1. What factors specifically can impede effective condom negotiation?
2. Why are young women increasingly acquiring HIV in South Africa?
3. How will the tenofovir gel need to be administered/distributed in order to effectively decrease HIV incidence in sub-Saharan Africa.

For more information on the tenofovir gel, see the website for CONRAD at Eastern Virginia Medical School: