Transcript Rectal microbicides Bridget Haire International Rectal Microbicides Advocates (IRMA) Overview • Women and men have anal sex • Vaginal microbicides will be used ano/rectally • Rectal safety.

Rectal microbicides
Bridget Haire
International Rectal
Microbicides Advocates (IRMA)
Overview
• Women and men have anal sex
• Vaginal microbicides will be used
ano/rectally
• Rectal safety evaluation
microbicide products is ongoing
• Rectal microbicide advocacy
Receptive anal sex
• Highest risk sexual activity
• Frequently invisible in research on
heterosexuals – tendency toward
making assumptions about the
nature of male/female sexual
practice
• Women who have receptive vaginal
and anal sex are likely to use the
same product in both places
Is a rectal microbicide
possible?
Against
• Hard enough in
the vagina
• Surface area too
big, mucosa too
delicate
For
• If PrEP is
plausible, then
the rectum is a
site for topical
PrEP
• Ian McGowan
and Peter Anton
think so.
Heterosexual anal sex
US
•
Ian McGowan
Outside the US
•
Ian McGowan
Anal sex and risk
• Information is relatively poor –
reflects lifetime practice rather than
giving an idea about frequency
• Risk of HIV is 5-80 times greater in
unprotected anal than unprotected
vaginal sex
• Some new data shows a confluence
of HIV risk factors in hetro anal sex
in young adults at US STI clinics
(Gorbach 2008)
The lesson..
• Advocacy focused on getting
better information about sexual
practice is critical to get
researchers to ask the right
questions and understand the
answers – “heterosexual
transmission” is not the most
useful category.
Safety studies
•
Ian McGowan
IRMA
IRMA mission
• Accelerate research
• Rectal safety studies on viable
vaginal microbicides
• Provide a central forum for
exchange and debate on RM and
NPT
• Convene diverse perspectives
and scientific disciplines
Advocacy achievements
• Consensus statement on rectal safety of
vaginal products
• Watch dog on unproven products making
claims of efficacy (Kirklees Medical Ltd)
• Survey on lubricants used for anal sex had
8,945 responses from 107 countries in 6
languages
• Two publications: Investments and
Advocacy and Less Silence, More Science
• Fundraising with AmFAR dedicated to
research on rectal transmission
Goals
•
•
•
•
Increase funding
Diversify funding sources
Recruit new researchers
Advocate for more international
research into anal sex and rectal
HIV transmission
• Encourage safety testing of more
commercial lubricants
• Develop a global RM development
plan
Thanks