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New HIV prevention study for women launched
Community Radio Harare
September 16, 2009

A new HIV prevention study for women has been launched in Harare today. Local and international researchers hoping that some of the antiretroviral (ARV), in particular tenofovir and truvada, medications used to treat HIV can also protect women from getting infected, have begun a new, large-scale clinical trial testing in two approaches.

The VOICE Study (Vaginal and Oral Interventions to Control the Epidemic) will help determine whether applying a vaginal microbicide gel containing an ARV or taking an oral ARV tablet daily can reduce a woman's risk of acquiring HIV. The study's primary aim is to evaluate the safety and effectiveness of the two - tablet or gel - women will actually be inclined to use. It is the first HIV prevention trial testing these two different approaches in the same study and the first effectiveness trial of a microbicide in which women use the gel every day instead of only around the time of sex.

"The HIV prevention field has not been without its share of disappointments and so, naturally we are excited that in VOICE we have not just one, but two promising approaches to evaluate. Hopefully, we'll find that ARVs, which helped turn the tide in the treatment of HIV, can be a prevention powerhouse too," said Zimbabwe study leader, Prof Mike Chirenje, who is also of the department of obstetrics and gynecology at the University of Zimbabwe.

"Here in Zimbabwe and elsewhere in Sub-Saharan Africa, women desperately need reliable and safe methods for preventing HIV that they can control themselves and so we are determined to find the best way to protect them. It is also important that these studies are starting from this region where HIV infection is more severe," added Nyaradzo Mgodi who is also leading the VOICE study in Zimbabwe.

Asked about what happened with the previous Microbicide Trials Network (MTN) research that showed that PRO 2000 Gel could be used 30% effectively to prevent male to female HIV infection, Mgodi said that gel had been taken for higher testing with the view of seeing how it could be improved to become more efficient..

Women represent nearly 60% of adults living with HIV in sub - Saharan Africa. In several southern African countries young women are at least three times more likely to be HIV-positive than young men. In Zimbabwe, UNAIDS estimates that of the 15% of adults living HIV, 54% of them are women. Although correct and consistent use of male condoms has been shown to prevent HIV infection, women often cannot control if or when condoms are used by their male partners. Moreover, women are twice as likely as their male partners to acquire HIV during unprotected sex, due in part to biological factors that make them more susceptible to infection.

Up to 5 000 women will be enrolled in VOICE at clinical trial sites in Zimbabwe (of which 600 of them will be from Harare and Chitungwiza), Uganda, South Africa and Zambia and will be studied by the US National Institutes of Health - funded MTN. All participants will receive regular HIV testing and risk-reduction counseling, condoms, and testing and treatment of sexually transmitted infections (STIs). This service is also extended to the women's partners.

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