Vaginal microbicides: A novel approach to preventing sexual transmission of HIV

2004 ◽  
Vol 1 (1) ◽  
pp. 25-32 ◽  
Author(s):  
Gustavo Doncel ◽  
Christine Mauck
Keyword(s):  
Sexual Transmission ◽  
Vaginal Microbicides ◽  
Novel Approach ◽  
Sexual Transmission Of Hiv

scholarly journals Chitosan-Based Mucoadhesive Vaginal Tablets for Controlled Release of the Anti-HIV Drug Tenofovir

Pharmaceutics ◽  
2019 ◽  
Vol 11 (1) ◽  
pp. 20 ◽  
Author(s):  
Raúl Cazorla-Luna ◽  
Fernando Notario-Pérez ◽  
Araceli Martín-Illana ◽  
Roberto Ruiz-Caro ◽  
Aitana Tamayo ◽  
...  
Keyword(s):  
Sexual Transmission ◽  
Microstructural Characterization ◽  
Vaginal Fluid ◽  
Vaginal Mucosa ◽  
Vaginal Microbicides ◽  
Polyelectrolyte Complexes ◽  
Antiretroviral Drug ◽  
Sexual Transmission Of Hiv ◽  
Self Protection

Vaginal microbicides have the potential to give women at high risk of contracting HIV the option of self-protection by preventing the sexual transmission of the virus. In this paper, mucoadhesive vaginal tablets based on chitosan, alone and in combination with pectin and locust bean gum, were developed for the sustained release of tenofovir (an antiretroviral drug). The formulations were placed in simulant vaginal fluid (SVF) to swell, and Hg porosity and SEM microscopy were used for the microstructural characterization of the swelling witnesses. The results show that the association of pectin and chitosan generated polyelectrolyte complexes and produced a robust system able to maintain its structure during the swelling process, when small pores are formed. Drug release and bovine vaginal mucoadhesion studies were performed in SVF showing that tenofovir-controlled dissolution profiles and adhesion to the mucosa were conditioned by the swelling processes of the polymer/s in each formulation. Tablets based on chitosan/pectin have the most homogeneous tenofovir dissolution profiles and last up to 96 h, remaining attached to the vaginal mucosa for the same period. These formulations can therefore be considered a good option for the self-protection of women from the sexual transmission of HIV.

Acceptability of tenofovir gel as a vaginal microbicide among women in a phase I trial a mixed-methods study,

2020 ◽  
Author(s):  
Lungwani Muungo
Keyword(s):  
Clinical Trials ◽  
Phase I ◽  
Phase I Trial ◽  
Hiv Transmission ◽  
Sexual Transmission ◽  
Initial Product ◽  
Vaginal Microbicides ◽  
Tenofovir Gel ◽  
Gender Based ◽  
Sexual Transmission Of Hiv

THE GLOBAL HIV EPIDEMIC increasingly affectswomen.1 For most, the only risk factor for becominginfected is the behavior of their male sexualpartners.1 Condoms often are unacceptableand insufficiently used,2–4 gender-based powerimbalances can make them difficult to negotiate,4–7 and religious beliefs, fertility needs, fear ofimplied infidelity, and preferences for sex withouta barrier are challenges to their acceptabilityand use. Women-initiated HIV prevention methodsare urgently needed, making the developmentof vaginal microbicides that reduce the likelihoodof sexual transmission of HIV a majorpublic health priority.First-generation vaginal microbicides will mostlikely be topical gels inserted into the vagina withan applicator. A variety of microbicides is currentlyunder development, and six have enteredlate-stage clinical trials.8–12 Initial product acceptabilityhas been assessed in clinical trials,13–16 surveysof product attributes among potentialusers17,18 and their partners,19 and studies that useover-the-counter (OTC) surrogates or placebo gelwith presumed similar formulation and applicationcharacteristics as eventual products.20–23 Acceptabilityassessments in early clinical trials areespecially important because their findings can influencefurther development of the product.Here, we report on acceptability data amongwomen participating in a phase I trial of tenofovirgel, a candidate microbicide that inhibits HIV reversetranscriptase. Details of the trial are reportedelsewhere,24 as is acceptability amongmale partners of trial participants.25 This was thefirst human trial of a topical antiretroviral thatspecifically inhibits a necessary replication stepin the HIV life cycle. Interest in this approach toHIV prevention has increased in recent yearssince efficacy trials of a topical surfactant(nonoxynyl-9) and a nonspecific inhibitor of HIVbinding (cellulose sulfate) indicated that thesetwo types of compounds were not protective andpotentially increased HIV transmission in womenwho had frequent sexual exposures to HIV. Severallarger-scale, expanded safety and proof-ofconcepttrials of tenofovir gel are now underway,based in part on the safety, tolerability, and acceptabilityof this microbicide demonstrated inthe study described in this paper.

scholarly journals Dapivirine Bioadhesive Vaginal Tablets Based on Natural Polymers for the Prevention of Sexual Transmission of HIV

Polymers ◽  
2019 ◽  
Vol 11 (3) ◽  
pp. 483 ◽  
Author(s):  
Raúl Cazorla-Luna ◽  
Araceli Martín-Illana ◽  
Fernando Notario-Pérez ◽  
Luis-Miguel Bedoya ◽  
Paulina Bermejo ◽  
...  
Keyword(s):  
Sexual Transmission ◽  
Vaginal Fluid ◽  
Natural Polymers ◽  
Vaginal Microbicides ◽  
Realistic Option ◽  
Sub Saharan ◽  
Sexual Transmission Of Hiv ◽  
Prevention Of Sexual Transmission ◽  
Exposure Prophylaxis ◽  
Self Protection

Young sub-Saharan women are a group that is vulnerable to the sexual transmission of HIV. Pre-exposure prophylaxis through vaginal microbicides could provide them an option for self-protection. Dapivirine has been demonstrated to have topical inhibitory effects in HIV, and to provide protection against the sexual transmission of this virus. This paper reports on the studies into swelling behaviour, bioadhesion and release carried out on dapivirine tablets based on chitosan, locust bean gum and pectin, to select the most suitable formulation. The modified simulated vaginal fluid led to a high solubility of dapivirine and allowed the dapivirine release profiles to be characterized in sink conditions; this aqueous medium is an alternative to organic solvents, which are not a realistic option when evaluating systems whose behaviour varies in aqueous and organic media. Of the formulations evaluated, dapivirine/pectin tablets containing 290 mg of polymer and 30 mg of dapivirine present the most moderate swelling, making them the most comfortable dosage forms. Their high bioadhesive capacity would also allow the formulation to remain in the action zone and release the drug in a sustained manner, pointing to this formulation as the most promising candidate for future evaluations of vaginal microbicides for the prevention of HIV.

Risk and vulnerability of key populations to HIV infection in Iran; knowledge, attitude and practises of female sex workers, prison inmates and people who inject drugs

Sexual Health ◽  
2014 ◽  
Vol 11 (6) ◽  
pp. 568 ◽  
Author(s):  
Razieh Khajehkazemi ◽  
AliAkbar Haghdoost ◽  
Soodabeh Navadeh ◽  
Hamidreza Setayesh ◽  
Leily Sajadi ◽  
...  
Keyword(s):  
Sex Workers ◽  
Female Sex Workers ◽  
People Who Inject Drugs ◽  
Sexual Transmission ◽  
Study Data ◽  
Prison Inmates ◽  
Female Sex ◽  
Comprehensive Knowledge ◽  
Sexual Transmission Of Hiv ◽  
Hiv Aids

Background In this study data of three national surveys conducted among female sex workers (FSW), prison inmates and people who inject drugs (PWID) were presented and compared in relation to knowledge, attitude, and practises. Methods: The surveys were conducted in 2009 and 2010 and included 2546 PWID, 872 FSW and 5530 prison inmates. Knowledge, attitude and practises towards HIV were measured through similar questions for each category. Results: Over 90% of all participants had ever heard of HIV/AIDS, although only approximately half of them perceived themselves at risk of contracting HIV. More than 80% were able to correctly identify the ways of preventing the sexual transmission of HIV; while more than two-thirds did not use condom in their last sexual contact. Approximately 20% of prisoners and FSW had a history of injecting drugs. Among all participants who have injected drugs, prisoners had the highest unsafe injecting behaviour at the last injection (61%), followed by FSW (11%) and PWID (3%). Conclusions: Despite major efforts to control the HIV epidemic in Iran, the level of risk and vulnerability among prisoners, FSW and PWID is still high. The level of comprehensive knowledge about HIV/AIDS is relatively good; however, their risk perception of contracting HIV is low and high-risk behaviours are prevalent. Therefore, HIV prevention programs should be redesigned in a more comprehensive way to identify the best venues to reach the largest number of people at a higher risk of contracting HIV and decrease their risk overlaps and vulnerability factors.

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