With half of the 2.5 million Indians infected with HIV being women,researchers are developing women controlled methods that include vaginal microbicides and female condoms to prevent HIV. At National AIDS Research Institute,a phase II safety and acceptability trial of a non medicated vaginal ring among 150 healthy uninfected women will get underway. Dr Mallika Alexander,medical manager of the Clinical Trial Unit at NARI,said that earlier a rubber ring was inserted inside the vagina for women who had prolapse of the uterus. Now,with even being flexible vaginal rings being used as contraceptives abroad,NARI too has decided to place non medicated vaginal rings in women to study if they can be used safely and continuously,she added. In Pune,the prevalence of HIV among women is less than one per cent. While behaviour modifications (abstinence and monogamous relationship) and condom use are the only preventive measures,there clearly is an urgent need to develop women controlled methods that can be used without depending on the husband for protection from HIV,said Alexander. Some of the methods that are being researched towards this end include vaginal microbicides and female condoms. Female condom is a strong,flexible,lubricated polyurethane sheath,about 17 centimetres (6.7 inches) long,with a flexible ring at each end. The closed end is inserted into the womans body,and the open end remains outside during intercourse. Like the male condom,it offers dual protection against unintended pregnancy and sexually transmitted infections,including HIV. Subsidized female condoms have been provided by the National AIDS Control Organisation (NACO) to high-risk women in the four states of Tamil Nadu,Maharashtra,Andhra Pradesh,and West Bengal. Vaginal microbicide is a medicinal or herbal product used intravaginally to prevent STDs including HIV. Microbicides prevent vaginal transmission of HIV through various mechanisms. These include inactivation of the virus in the vagina itself,prevention of the virus from entering into the hosts cell,by decreasing the vaginal pH which inactivates the virus and forming an invisible lining for the vagina that acts as a barrier between the virus and the vagina. Some of the Anti Retro Viral drugs are also being developed as microbicides. Currently,safe and effective microbicides to block HIV are not yet available,but globally,11 microbicides and 6 Anti Retro Viral (ARV) based HIV prevention products are in 38 clinical trials,of which two candidates are in Phase III trials. NARI has successfully conducted five phase 1 trials of PRO gel,buffer gel,praneem and nonoxynol 9 all microbicide candidates and two phase II trials of praneem and tenofovir gel. This fresh study will be launched to provide answers to how long a vaginal ring can be used continuously and safely,said Alexander.
