Science, medicine, and the future: Microbicides in HIV prevention

McCormack, Sheena; Hayes, Richard; Lacey, Charles; Johnson, Anne M

doi:10.1136/bmj.322.7283.410

Cited by 46 publications

(7 citation statements)

References 11 publications

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“…In the United States, the number and proportion of HIV/AIDS cases among black/African Americans continue to highlight the need for new biomedical prevention interventions, including an HIV vaccine, microbicide, or new ARV-based prevention strategies such as pre-exposure prophylaxis (PrEP) to complement existing condom usage, harm reduction methods, and behavioral change strategies (Berkley and Koff 2007; Liu et al 2006; McCormack et al 2001; Potts 1994; Youle and Wainberg 2003). In 2006, black/African American women constituted 61% of the estimated 54,230 domestic female incident HIV cases, and subgroup estimates among young (ages 13–29) black men-who-have-sex-with-men (MSM) demonstrate a rate 7.1 times greater than for white men in the same age group (Prejean et al 2008).…”

Section: Introductionmentioning

confidence: 99%

An Extended Model of Reasoned Action to Understand the Influence of Individual- and Network-Level Factors on African Americans’ Participation in HIV Vaccine Research

Frew

Archibald

Diallo³

et al. 2009

Prev Sci

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In the United States, the number and proportion of HIV/AIDS cases among black/African Americans continue to highlight the need for new biomedical prevention interventions, including an HIV vaccine, microbicide, or new antiretroviral (ARV) prevention strategies such as pre-exposure prophylaxis (PrEP) to complement existing condom usage, harm reduction methods, and behavioral change strategies to stem the HIV epidemic. Although black/African Americans are disproportionately impacted by HIV/AIDS, their participation in HIV clinical research continues to have unique challenges. We theorize that interaction among multilevel factors creates ideal alignment for minority participation in HIV clinical studies. Thus, we initially set out to test an extended model of reasoned action with 362 participants to understand the interplay of sociopsychological and network-level considerations influencing minority participation in HIV prevention research efforts. In this study, we linked the intrapersonal dimensions of attitudes, beliefs, and normative concerns to community-level components, appraisal of involvement with the clinical research organization, an entity which operates within a networked structure of community partner agencies, and identification with coalition advocacy aims. Various participatory outcomes were explored including involvement in future HIV vaccine community functions, participation in community promotion of HIV vaccine research, and community mobilization. Three-stage least squares estimates indicated similar findings across three models. Significant effects demonstrate the importance of positive attitudes toward HIV vaccine research, favorable health research beliefs, perceived social support for participation, HIV/AIDS issue engagement, and perceived relevance of the clinical research site’s mission and values. Identification of these nuanced pathway effects provides implications for tailored community program development.

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Section: Introductionmentioning

confidence: 99%

An Extended Model of Reasoned Action to Understand the Influence of Individual- and Network-Level Factors on African Americans’ Participation in HIV Vaccine Research

Frew

Archibald

Diallo³

et al. 2009

Prev Sci

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“…Sodium docusate is an anionic amphiphile. (CH 2 ) 8 (OCH 2 CH 2 ) n OH H 3 C N + (CH 2 ) n CH 2 Nonoxynol-9 (N-9) is a nonionic amphiphile that is commonly used as an over-the-counter, spermicidal contraceptive in the UK and USA. Globally, women also use the cationic amphiphile benzalkonium chloride and the anionic amphiphile sodium docusate as vaginal spermicides.…”

Section: Amphiphilesmentioning

confidence: 99%

“…As outlined by Potts [1] in 1994, women are at greater risk of STIs than men for several reasons: (1) Human Immunodeficiency Virus (HIV) is more easily passed from men to women than vice versa; (2) women acquire the virus at an earlier mean age than men; (3) women are frequently sexually assaulted; and (4) women can transmit disease to their offspring through pregnancy, delivery, or breast feeding. The worldwide increase in HIV infections among women has made developing user-controlled, topical vaginal microbicides that provide protection against STIs an urgent global priority [2].…”

Section: Introductionmentioning

confidence: 99%

“…Several chemical agents have been designed to slow the spread of HIV infections. Ideally, vaginal microbicides, with or without contraceptive properties, should be (1) highly active against pathogenic microorganisms and, in the case of contraceptive microbicides, highly active against sperm, (2) efficacious and fast-acting in vivo, (3) safe, (4) nonabsorbable, (5) stable, (6) easy to formulate, (7) bioadhesive, (8) acceptable and appealing to the users, and (9) inexpensive [4]. As several recent excellent reviews [5][6][7][8][9][10] attest, the search continues for chemical agents that simultaneously protect against pregnancy and infection.…”

Section: Introductionmentioning

confidence: 99%

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Toward a Design of Affordable, Topical Microbicides: Acylcarnitine Analogues

Gandour¹

2005

CPD

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Most heterosexual women want to reduce the risk of acquiring a sexually transmitted infection; many also want to control their fertility. Several chemical agents have been proposed to dramatically slow the spread of HIV infections. Ideally, vaginal microbicides, with or without contraceptive properties, should be safe, effective, and affordable for women everywhere. Amphiphiles, which are surfactants that can act as detergents, have a long history as microbicides against many pathogens. Amphiphiles have several desirable traits; e.g., they are inexpensive, fast-acting, and capable of a broad spectrum of activity. An "ideal" amphiphilic microbicide will rapidly and selectively inactivate pathogens and sperm without irritating tissue. In this review, we discuss a homologous series of amphiphilic acylcarnitine analogues as microbicides. Two homologues, Z-14 and Z-15, possess excellent spermicidal, anti-HIV, anti-chlamydial, anti-gonorrhea, and anti-Haemophilus activities; both have outstanding anti-Candida activity. A 4% Z-15 gel that is comprised of 3% carboxymethylcellulose in water gives a dramatically low score in a rabbit-vaginal-irritation study. The mechanisms of action of these compounds are not fully understood as yet, but we present several possibilities. Moreover, the results of our limited structure-activity study with a homologous series have stimulated additional questions and ideas for designing the next generation of microbicidal amphiphiles. The above studies support the idea that Z-14 and Z-15 can potentially serve as safe (non-irritating), effective topical microbicides.

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“…More than 60% of people living with HIV in the world live in sub-Saharan Africa (around 25.4 million people), and statistics show around 11.5 million women in 2004 in this part of the world were infected compared with around 10 million men [1]. There is still an urgent need for additional methods to prevent the heterosexual transmission of HIV, and vaginal microbicides, which would remain under the control of women, are being developed as part of the global response to this need [2,3].…”

Section: Introductionmentioning

confidence: 99%