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RESEARCHERS conducting clinical trials to search for a microbicide that can help prevent HIV infection in women in Africa and other parts of the world often battle with negative perceptions surrounding their work.
Zimbabwe has a number of HIV prevention studies that are being conducted. One of the biggest studies taking place is known as the Vaginal and Oral Interventions to Control the Epidemic (Voice).
The study seeks to establish whether an Antiretroviral (ARV) drug taken either as a vaginal microbicide gel or as an oral tablet by HIV-negative women every day before sex can prevent new infections.
Senior Reporter Bertha Shoko (BS) spoke to researcher and director of the Microbicides Trials Network, which operates under the auspices of the University of Zimbabwe in collaboration with the University of California-San Francisco (UZ-UCSF) Nyaradzo Mgodi (in picture) (NM) to establish the ethical considerations taken before the research and guarantees for protection given to women before they take part in the clinical trials.
BS: What is a microbicide?
NM: A microbicide is a chemical that can substantially reduce transmission of sexually transmitted diseases when applied in the vagina.
A microbicide can be produced in many forms, including gels, creams, suppositories, films, lubricants, or in the form of a sponge or a vaginal ring that slowly releases the active ingredient.
BS: Are microbicides currently available for use by women?
NM: No. Scientists are currently testing many substances to see whether they help protect against HIV or other sexually transmitted diseases (STIs) but no safe and effective microbicide is currently available to the public.
However, scientists are seriously pursuing dozens of product leads, including 16 that have proven safe and effective in animals and are now being tested in people.
If one of these leads proves successful, and with sufficient investment, a successful microbicide could be on the market by the end of the decade.
BS: How important is the development of microbicides for women?
NM: Over 60% of adults living with the virus in the world are in the sub-Saharan region and if we look at the sub-Saharan region only over 60% of the adults living with the disease are women, so the burden of the disease in women is very high.
So if you look at other proven methods of preventing HIV, for example condoms, we find that most women find it difficult to negotiate for condom use because of gender disparities; this is a culture in which the man is the dominant partner so what we would like to do is to develop a chemical which a woman can use vaginally without having to depend on her man.
That is why we came up with this idea of a microbicide. It is very important because the majority of people living with HIV in this region are women.
BS: As a researcher how would you respond to people who say that HIV researchers are using women and exposing them to HIV?
NM: All clinical trials in Zimbabwe and all over the world are conducted under the strictest ethical considerations.
In Zimbabwe we are governed by the Medical Research Council of Zimbabwe (MRCZ), which falls under the Research Council of Zimbabwe, the highest institution regulating studies in the country.
Before any study is conducted we have to seek and obtain approval from MRCZ.
BS: After being granted approval by the MRCZ what steps are taken to ensure that women participating in any clinical trials go in with an open mind?
NM: All women who take part in our studies sign what is known as informed consent form.
This informed consent form tells women what the study is all about, what they are expected to do, what they may expect of us researchers, the benefits of the research and if there are any, the risks of the research.
So before a woman joins a study she has to go through this informed consent form and then sign it. We even give her a chance to take it home so she can discuss with her spouse and other family members so she really understands what is expected of her.
We don’t consider women who take part in these trials as “guinea pigs”; this is crude. For us, women who take part in these trials are heroines as they are playing a part in HIV prevention.
During the study women are encouraged to use condoms each time they have sex and to seek early treatment for STIs.
BS: What role can the media play in HIV prevention research and in allaying fears and correcting misconceptions?
NM: The media’s role is in many ways to educate communities so that when we researchers come in to discuss our studies people don’t greet us with suspicion and they know what we are talking about.
Most people are wary of researchers but the media is a very powerful tool, which can help change people’s negative perceptions.
By Bertha Shoko
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