UNAIDS Calls for Continued Commitment to Microbicides

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S IIIIIIIIIIIIIII III 111111 Uliii II Durban, 12 July 2000
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UNAIDS CALLS FOR CONTINUED COMMITMENT TO MICROBICIDES
Durban, South Africa, 12 July 2000 - The Joint United Nations Programme on HIV/AIDS
(UNAIDS) has called for continued commitment to finding a microbicide against HIV despite the
negative results of recent trials of the spermicide nonoxynol-9.
Test results released on 13 June revealed that the product, marketed under the trade name
'Advantage S' in the United States and China, was not only ineffective against HIV but actually
harmful as a microbicide.
"We were dismayed to find out that the group using the N-9 gel had a higher rate of HIV infection
than the group using a placebo," said Dr Joseph Perridns, who heads the UNAIDS microbicide
effort. "The active group had 59 infections, while the placebo group had 41. This is a significant
difference."
"While the incidence of HIV infection in both groups in this study was lower than that seen in the
untreated population from which volunteers were recruited, it is clear that the rate of infection was
greater with the N-9 gel compared to its placebo control preparation," Dr Perriens added. "Despite
these results, we have lost a battle, not the war. We know N-9 is not the answer- so we need to
continue our search."
As a result of the trial, UNAIDS is calling for an acceleration of the introduction of new more
promising microbicides into large-scale Phase III trials. "A microbicide can allow women to protect
themselves and their partners from infection without necessarily having to secure male
cooperation," said Awa Coll-Seck, Director of Policy, Strategy and Research for UNAIDS. Three
products currently in advanced safety testing in women could be available for inclusion in
combined safety/efficacy evaluation within months, and the safety testing of a further 10 products,
including two antiretrovirals, should also be accelerated. Ten public agencies are currently
members of the International Working Group on Microbicides working on microbicide
development. These efforts, however, lack adequate funding.
Meanwhile, UNAIDS believes that women at high-risk of HIV infection should not use
N.-9, given that the bulk of the data now suggests that it is either ineffective or harmful as an antiHIV agent.

The study was conducted as a triple-blind multicentre trial among female sex workers. Women
were chosen at random from volunteers who were informed of the risks and who agreed in writing
to lake part in the tests. They benefited from condom promotion, free condoms and free treatment
of sexually transmitted infections. Test sites were located in Benin, Cote d'lvoire, Thailand and
South Africa.