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Global meet emphasises new approaches to HIV prevention

Aarti Dhar

TORONTO: New approaches to HIV prevention, including microbicides and circumcision, have pushed the debates on anti-AIDS vaccines into the background. This is evident at the XVI International Conference on AIDS that is hearing more people talk about accelerating research in alternative prevention options than just vaccines. A range of promising new HIV prevention approaches are currently under investigation.

If shown to be effective, these new tools and strategies could help avert millions of fresh infections, and have a substantial impact on the course of HIV/AIDS epidemic, according to the Global HIV Prevention Working Group — a panel of 50 leading public health experts, clinicians, biomedical and behavioural researchers. HIV prevention is likely to be enhanced by use of a combination of behavioural and biomedical interventions, said Gita Ramjee of the Working Group.

The current research on biomedical interventions includes vaginal and rectal microbicides, antiviral treatment for HIV prevention and as a pre-exposure prophylaxis, male circumcision and cervical barrier methods as also vaccines. Some of these new prevention methods — male circumcision, cervical barriers, pre-exposure prophylaxis with antivirals, and herpes suppression — could potentially be shown to be effective within the next few years .

Many of these new HIV prevention methods could be particularly beneficial for women, who represent approximately one-half of people living with HIV in sub-Saharan Africa since many women have difficulty negotiating abstinence and condom use with male partners, especially in countries where women lack legal rights and are economically dependent on men.

Observational studies have shown that countries with high rates of male circumcision have lower HIV infection rates and trials are on in Kenya and Uganda. However, so far India has preferred to keep itself away from making any commitment on the issue because of religious sentiments involved with it. "In India, it is a contentious issue and there is caution on the issue,'' said Shivananda Khan of the NAZ Foundation. Political and religious considerations need to be taken into account and some Hindu religious groups have already taken up the issue by describing it as a deliberate attempt for conversion, he said adding.

Clinton statement

Not in total agreement with the concept of abstinence from sex to prevent the spread of HIV infection, the former U.S. President Bill Clinton on Tuesday said abstinence should be part of a comprehensive prevention policy that included other interventions. "I am not against any religion or philosophy that promoted abstinence but it is not a practical solution. There is evidence to show that abstinence is not always successful,'' he told reporters here.

Earlier, Mr. Clinton criticised the U.S. administration for its support of abstinence-based programmes to fight HIV/AIDS and spoke in favour of "needle-exchange'' programme and safe injection sites to reduce infection among the drug users.

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