Vaginal microbicide

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Vaginal microbicide
Specialty Gynecology

A vaginal microbicide is a microbicide for vaginal use, generally as protection against the contraction of a sexually transmitted infection during vaginal sexual intercourse. Vaginal microbicides are topical gels or creams inserted into the vagina.

Contents

Target market

Researchers have investigated who has interest in using a vaginal microbicide. Condoms are highly effective in preventing the transmission of infection, but worldwide, the decision to use condoms is more often a decision made by males than females. [1] A vaginal microbicide which could prevent sexual transmission of infection would further empower women to influence the result of their sexual encounters. [1] The demographic interested in using the produce included women with the following characteristics: [2]

* use condoms to prevent infection

The number of women interested in using such a product has been characterized as being significant enough to merit product development and marketing. [2]

Characteristics

The ideal vaginal microbicide would have the following characteristics: provide protection against infection not require application at the time of intercourse not harm the natural tissue [3] As of 2009, not harming natural tissue was the most troublesome aspect of development. [3]

For HIV

Studies for using vaginal microbicides for HIV treatment rapidly increased through 2011 to 2013 due mostly to the observation that antiretroviral drugs designed for HIV treatment sometimes also achieve preexposure prophylaxis and significantly reduced HIV risks. [4] Several unrelated chemical mechanisms have been proposed for vaginal microbicides treating HIV. [1] One obstacle to effective research is that trials may involve social harms for trial participants, although one 2019 study found these social harms to be relatively small. [5] There is also often a self-reporting bias in condom and vaginal microbicide use in trials, suggesting the need for vaginal applicator staining to confirm whether the vaginal microbicides were effectively applied. [6]

Surfactants

The first vaginal microbicide studied was nonoxynol-9, which acted as a surfactant. [1]

Blocking HIV binding

PRO 2000, carrageenan, and cellulose sulphate have been studied as microbicides to block HIV binding. [1]

Topical antiretrovirals

Tenofovir has been studied as a topical antiretroviral. [1] One example of a tenofovir study is CAPRISA 004 in 2010, finding its use reduced HIV infection risk by 39% overall. [4]

See also

Related Research Articles

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<span class="mw-page-title-main">Microbicides for sexually transmitted infections</span> Pharmacologic agents and chemical substances

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<span class="mw-page-title-main">Vaginal lubrication</span> Natural lubrication of the vagina during sexual arousal

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<span class="mw-page-title-main">Personal lubricant</span> Substance to reduce friction, usually during sexual acts

Personal lubricants are specialized lubricants used during sexual acts, such as intercourse and masturbation, to reduce friction to or between the penis and vagina, anus or other body parts or applied to sex toys to reduce friction or to ease penetration. Surgical or medical lubricants or gels, which are similar to personal lubricants but not usually referred to or labelled as "personal" lubricants, may be used for medical purposes such as speculum insertion or introduction of a catheter. The primary difference between personal and surgical lubricants is that surgical lubricants are thicker, sterile gels, typically containing a bacteriostatic agent. As of 2015 the personal lubricant market was estimated to be worth at least $400 million.

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iPrEx

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PRO 2000 is an experimental vaginal microbicide which has been proposed as a preventive medicine for reducing the risk of contracting HIV. It has never been recommended as an effective medicine to be used for any purpose. Some clinical trials have shown that under some conditions it may provide some protection against HIV.

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Elizabeth Anne Bukusi FAAS is a research professor working within the field of obstetrics and gynaecology, and global health. Bukusi's main areas of research focus around sexually transmitted infections, women's health, reproductive health, and HIV care, prevention and treatment. Bukusi is the Chief Research Officer at the Kenya Medical Research Institute (KEMRI) and led a "landmark" study on the use of PrEP in Kenya.

<span class="mw-page-title-main">Dapivirine Ring</span> Antiretroviral vaginal ring

Dapivirine (DPV) Ring is an antiretroviral vaginal ring pioneered by the International Partnership for Microbicides (IPM) pending for regulatory review. It is designed as a long-acting form of HIV prevention for at-risk women, particularly in developing nations such as sub-Saharan Africa. IPM has rights to both the medication and the medical device. A total of four rings with different drug diffusion systems and polymer composition have been developed by IPM. The latest design, Ring-004, is a silicone polymer matrix-type system capable of delivering DPV intravaginally in a sustained manner.

Sharon Louise Hillier is an American microbiologist. She is the Richard Sweet Endowed Chair in Reproductive Infectious Disease and vice chair of the department of obstetrics, gynecology and reproductive sciences at the University of Pittsburgh Medical Center (UPMC) and Magee-Women's Research Institute.

References

  1. 1 2 3 4 5 6 Weber, J.; Desai, K.; Darbyshire, J.; Microbicides Development Programme (2005). "The Development of Vaginal Microbicides for the Prevention of HIV Transmission". PLOS Medicine. 2 (5): e142. doi: 10.1371/journal.pmed.0020142 . PMC   1140953 . PMID   15916473.
  2. 1 2 Darroch, Jacqueline E.; Jennifer J. Frost (January–February 1998). "Women's Interest in Vaginal Microbicides". Family Planning Perspectives. 31 (1): 16–23. doi:10.2307/2991552. JSTOR   2991552. PMID   10029928 . Retrieved 21 November 2011.
  3. 1 2 Laurence, Jeffery; Johnston, Rowena (19 February 2009). "The Promise of an Effective Vaginal Microbicide". amfar.org. Archived from the original on 23 March 2011. Retrieved 20 November 2011.
  4. 1 2 Stone, Alan B.; Harrison, Polly F.; Lusti-Narasimhan, Manjula (2013-09-10). "Microbicides from a regulatory perspective". AIDS. 27 (14): 2261. doi: 10.1097/QAD.0b013e32836239b4 . ISSN   0269-9370.
  5. Montgomery, Elizabeth T.; Roberts, Sarah T.; Nel, Annalene; Malherbe, Mariette; Torjesen, Kristine; Bunge, Katherine; Singh, Devika; Baeten, Jared M.; Marrazzo, Jeanne; Chirenje, Z. Mike; Kabwigu, Samuel; Beigi, Richard; Riddler, Sharon A.; Gaffour, Zakir; Reddy, Krishnaveni (2019-11-15). "Social harms in female-initiated HIV prevention method research: state of the evidence". AIDS. 33 (14): 2237. doi: 10.1097/QAD.0000000000002346 . ISSN   0269-9370.
  6. Mauck, Christine K.; Schwartz, Jill L. (2012). "Dyeing to Know: The Use of Vaginal Applicator Staining and Other Techniques to Assess Adherence to Product Use in Microbicide Trials". Sexually Transmitted Diseases. 39 (9): 713–715. ISSN   0148-5717.