Clinical trial for HIV prevention rings the changes
Researchers mine new methods to stem pandemic
ONTHANDO Kewana will soon know if her monthly trips to the Emavundleni Research Centre in Crossroads have made history.
For nearly two years, the 25year-old has been paying monthly visits to the centre to get a vaginal ring that slowly releases an antiretroviral into her body.
She is part of the final phase of a big clinical trial, and researchers expect to know by mid-2015 whether the ring can protect women from HIV.
“I was scared when I saw the ring, and I thought it might go all around my body. But I don’t even feel it,” Kewana said this week, as she waited for her monthly appointment. “My partner also can’t feel it.”
The ring is a white, silicone hoop about the size of the circle made when a woman’s thumb and forefinger join up.
More than 3 000 women around the continent are involved in the Aspire trial, which is testing whether the ARV called Dapivirine can protect women from HIV through the simple ring that stays in place for a month.
“I decided to come here to see if I can protect myself from HIV, because I am so scared of it,” said Kewana, who witnessed her older sister die of Aids.
Emavundleni is part of the Desmond Tutu HIV Foundation, headed by world-renown-
Ned HIV expert Professor LindaGail Bekker.
“This area encapsulates the worst of Cape Town’s HIV epidemic, with about 28 to 30 percent of pregnant women testing HIV positive,” said Bekker. “HIV is particularly high in the very informal parts, where people are newly urbanised and don’t have access to health care. That is why this research has to happen here.”
The centre was set up 10 years ago in a shipping container and has grown into a two-storey building.
Researchers have worked very hard to win the trust of community members and encourage them to take part in a number of HIV trials.
More than 500 people from Crossroads and Nyanga are involved in various HIV and TB prevention trials.
This week, the globe’s leading brains researching biomedical ways of preventing HIV met in Cape Town for the inaugural HIV Research for Prevention conference.
“We have six-and-a-half million people living with HIV in South Africa, and treating them with ARVs for the rest of their lives is an enormous public health undertaking. There is an urgency to turn off the taps (of infection) and come up with new prevention methods,” Bekker said.
Using antiretroviral medication to prevent – not just treat – HIV is emerging as one of the most powerful weapons to contain the epidemic in the absence of a vaccine.
ARVs taken immediately after HIV exposure – in rape cases or when health workers are injured by needles while treating HIV-positive patients – have been known to prevent HIV. However, the long-term aim is still a vaccine to prevent HIV and there are some promising developments.
The vaccine is now being modified to contain the strain of HIV most common in South Africa and by January next year, 200 more South Africans will be vaccinated with it. But it could leapfrog into a massive R1bn trial within a year if the people respond according to the Thai trial.
“We have already set our ‘go or no go’ criteria based on the Thai trial and if we meet these, we can go straight into a Phase 3 trial of 7 000 people by the end of 2016,” said the Medical Research Council president, Glenda Gray.– Health-e News