What impact would microbicides have?
The potential impact of microbicides in Johannesburg, South Africa: model projections and implications for product promotion
Targeted promotion of microbicides could significantly reduce HIV transmission in South Africa
Authors:
P Vickerman; C. Watts; S. Delany; H. Rees; International Family Health; Global Campaign for Microbicides; Reproductive Health Research Unit
Publisher:
International Family Health, UK, 2004
This briefing note, produced by International Family Health and the Global Campaign for Microbicides, summarises key findings from a modelling exercise that estimates the impact of a partially effective microbicide in Hillbrow, Johannesburg. Findings indicate that a relatively low efficacy microbicide can significantly reduce HIV transmission even in a high prevalence setting, if access to and use of microbicide is widespread. Impact on transmission is also greater in the earlier stages of the epidemic. The majority of HIV infections averted will be in casual and regular partnerships, where condoms are not normally used; whereas microbicides are unlikely to avert substantial infection in sexual partnerships that have high condom use. In these partnerships, such as commercial sex, condom migration (reduction in condom use) could negate the beneficial effects of a microbicide.
The authors conclude that care should be taken in marketing microbicides, even in settings where HIV is concentrated among the most vulnerable groups. They recommend that effective microbicides should be made quickly and widely available, but should be presented as a method to complement and enhance other prevention activities. In addition, microbicides should be promoted primarily in established casual and long-term stable partnerships where condom use is low. [adapted from author]
