FHI 360 has been at the forefront of research to identify an effective microbicide — a substance that could be used in the vagina or rectum to reduce the risk of HIV transmission during sex. The search has been driven by the urgent need for HIV prevention options that women can control or at least initiate.
The most advanced microbicide candidate is a vaginal gel formulation of the antiretroviral (ARV) drug tenofovir. FHI 360 supported the CAPRISA 004 study, which showed that tenofovir vaginal gel could reduce women’s risk of HIV infection. Independent scientific confirmation of that result is required before tenofovir gel can be approved for licensure and introduction; a study is under way, with results expected in 2014.
To speed access to microbicides once an effective product has been identified, the U.S. Agency for International Development (USAID) and its partners have begun to lay the groundwork for microbicide introduction. With USAID support, FHI 360 explored how to market a microbicide gel to women and analyzed how gender issues are likely to affect women’s microbicide use, including the role of male partners. These efforts produced recommendations and tools for future microbicide programs.
In addition to its work on tenofovir gel, FHI 360 has also contributed to the evidence base on other methods of ARV-based prevention. Our FEM-PrEP study highlighted the importance of better understanding of adherence to HIV pre-exposure prophylaxis among women at high risk of HIV infection.
Another study, Assessing Physical Delivery of PrEP in Support of Proof of Delivery, explored the most acceptable delivery channels for vaginal, oral and injectable ARV-based HIV prevention products and potential user preferences for product formulation. The study evaluated the potential impact of these new products on service quality and determined the additional capacity and support needed to integrate these products into existing services.