New HIV prevention methods providing rays of hope

TORONTO — The excitement at the world's largest AIDS conference was over microbicides that could help women in poor countries protect themselves from HIV in several years.

Yet AIDS experts warned Tuesday that the world is woefully unprepared to ensure widespread access to such treatments.

Promising tests for new HIV prevention approaches are nearly complete, yet many financial and ethical obstacles could delay or even derail completion of critical trials.

More than 40 million people worldwide are living with the virus that can lead to AIDS; 25 million of them have already died since the first cases of HIV were reported 25 years ago.

Testing of microbicides that could protect impoverished women who have little say over their health and bodies in sub-Saharan Africa, for example, will be complete by the end of next year. A topical microbicide to block HIV transmission could be available by 2010.

Recent studies in Africa suggest men can cut the risk of getting HIV from an infected partner by some 60 percent if he is circumcised; men with HIV also appear about one-third less likely to spread the virus if they've been circumcised.

Other hopeful approaches include cervical diaphragms, AIDS drugs used as preventives, the suppression of herpes — which boosts HIV risk up to three times — and the relentless search for an HIV vaccine.

"Very soon, we could have new, highly effective ways to prevent many of the 4 million new HIV infections that occur every year," said Helene Gayle, co-chair of the Global HIV Prevention Working Group as well as the international AIDS conference. "But these tools will have little impact in the real world unless we take immediate steps to complete current trials, mount new ones, and reach people most in need."

The Working Group, with dozens of leading AIDS and public health experts from around the world, was launched by the Henry J. Kaiser Family Foundation and the Bill & Melinda Gates Foundation.

In a report released Tuesday, the group noted that fewer than 1 in 5 people at high risk for HIV infection today has access to effective prevention, a rate deemed too low to have a significant impact on the course of the epidemic.