San Francisco Examiner - December 1, 2004
Jo Stanley, Staff Writer

San Francisco HIV researchers are putting their attention on branching out beyond behavioral prevention strategies that have been successful at limiting -- but not eliminating -- the disease.

"Vaccines hold promise," explained Dr. Susan Buchbinder of the Public Health Department's HIV Research Section on the eve of World AIDS Day, "because a relatively brief intervention could lead to long-term protection."

This week, she and other researchers announced a new vaccine test called Project T. The drug tenofovir has shown "promising" early results indicating it may safely boost the ability of the immune system's T cells to recognize and attack the virus.

Researchers vehemently dispute the notion that the once-a-day pill should be seen as some sort of morning-after pill because it may offer protection after exposure to HIV. The test is set up to monitor over several years whether the volunteers who participate stick to safe-sex behaviors or start to take more chances because they feel safer.

Half of the 50 local recruits will get a placebo, according to Buchbinder, and even those who receive the drug can't be sure it will offer some protection before or after exposure to HIV. That finding may come in a later series of tests if this phase is successful.

The international test, which includes 1,500 people, is being funded by the U.S. National Institute of Health. Other federal dollars are paying for San Francisco to participate in a test of whether a common herpes treatment called acyclovir may cut the rate of infection among 250 volunteers, since having herpes apparently makes a person twice as likely to contract HIV.

San Francisco has managed to cut its rate of infection to just 10 percent of what it was a quarter century ago, primarily with behavioral approaches to prevention, according to Buchbinder, but now needs to try new approaches because changing habits can be very challenging.

"As one of my colleagues at the NIH said, 'If behavioral change was easy, I'd be thin,'" she said.

Although these two studies will include only men who have sex with men, the doctors point out there are already six other vaccine tests under way locally, and as many more could be launched in the coming six months. Some of those involve female volunteers as well.

Only 6 percent of The City's roughly 1,000 new cases of HIV infection each year are women, according to the Health Department's new prevention-oriented Web site being launched to coincide with the international AIDS day. But California officials point out that statewide, the rate of HIV and AIDS infection is increasing faster among women than men and disproportionately affects the black and Hispanic communities.

San Francisco's HIV Web site address is located at www.sfhiv.org. Information about the new vaccine trials will be posted there, according to the doctors.

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