Important note: Information in this article was accurate in 2006. The state of the art may have changed since the publication date.
The New York Times - August 15, 2006
Lawrence K. Altman
Findings from some studies, like those assessing the effectiveness of microbicides and male circumcision, are expected within the next five years, some possibly in about a year, the panel said at the 16th International Conference on AIDS.
At the same time, a significant number of practical and ethical challenges threaten to slow or derail critical research on many prevention measures, the panel of international experts said.
The report focused on six H.I.V. prevention methods: male circumcision; diaphragms and other cervical barriers; on demand pre-exposure and post-exposure use of antiretroviral pills like Tenofovir to prevent infection among prostitutes and other people at high risk of becoming infected; suppression of herpes, which infects up to 70 percent of people in some parts of Africa; microbicides; and vaccines.
The need is urgent to make prevention measures of proved effectiveness widely available because four million people are becoming infected each year. ôThe harsh reality is we are quickly falling behind in H.I.V. prevention,ö Dr. Helene Gayle, the president of the International AIDS Society, which is the main organizer of the conference, said at a news conference.
None of the new prevention methods being tested is likely to be 100 percent effective, which will increase the difficulty of putting them into practice, the panel said.
The panel made a number of recommendations. They include finding ways to make sure male circumcision is carried out by trained health workers.
Another is developing new ethical guidelines to conduct clinical trials in poor countries because of the inadequacies of existing guidelines. Officials have stopped a small number of clinical trials of preventions in Cameroon and other countries because of embarrassing fiascos involving poor communications between researchers, volunteers for and participants in the trials, community leaders and government officials.
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