August 30, 2006

A Little Dab Will Do Ya: Chasing Down Microbicides

August 30, 2006—If there had been anti-HIV microbicide gel in Caroline Long’s San Diego bedroom 20 years ago, she might never have gotten the virus. But a tube of it would also come in handy right about now. “It would be like a miracle,” says Long, 39, who’s hoping a California campaign to accelerate microbicide research will finally help deliver this woman-empowering prevention tool.

The state campaign, a coalition of HIV prevention advocates and women’s groups, scored big earlier this month when it helped get Senate Joint Resolution 22 (SJR22) passed in the California Senate. While the resolution is a nonbinding show of support, advocates were able to put microbicide information in the hands of the state’s most powerful policymakers. It turns out very few of them knew that women constitute about half the positive population worldwide—not to mention how to pronounce the word “microbicide.” And the vote was reassuringly bipartisan.

“The work we do makes people take it more seriously,” says Bethany Young Holt, director of the California Microbicides Initiative (CaMI), and—she hopes—quickens the pace of legislative action at the federal level, where just over 2% of AIDS spending at the National Institutes of Health (NIH) goes to microbicide research.

The Microbicide Development Act of 2005, introduced to Congress late last year, would boost NIH funding and coordinate efforts with other federal organizations,  such as the Centers for Disease Control and USAID. Worldwide, five of 60 different vaginal microbicide options are in late-stage clinical trials, with results expected in 2008. Trials are underway on anal use as well.

Just as important as the politics and the funding, however, are the California advocates’ efforts to bring the microbicides of the future into the public imagination—especially women’s. Mariaelena Welch, chairperson of the California Junior League’s State Public Affairs Committee (SPAC), is amazed how few have even heard of microbicides. “Oh, my gosh,” she paraphrases women as telling her. “I didn’t understand that this was an option. I didn’t know this could be achieved in our lifetime.”

Welch firmly believes that “the more women know, the more outraged they will be when they realize they don’t have it yet.”

The push for microbicides is sometimes cast as a developing world issue, in which women in Europe and North America figure mostly for influence. That’s one aspect of the California-based initiative. But, as Welch points out, women will benefit “where ever the only other option for a woman to protect herself is abstinence or negotiating condom use.”

Not to mention the benefits of protecting others—and maybe even allowing women to conceive while blocking the virus, as researchers hope some of the new microbicides will do. Caroline Long’s urge to mother was one of the reasons she became exposed to the virus in the first place. “I didn’t protect myself like I should have because I wanted to have a child,” she says.

Long feels microbicides would give her back control of more than just her sex life. “If there were a gel that blocked the virus,” she says, “I’d have so much freedom. It’d almost be like I wasn’t positive.”