HIV/AIDS got a lot of press last week in the Canadian media, probably due to the International AIDS conference
New Development
One of the covered items is a new microbicide gel has been shown to reduce HIV transmission. It contains the drug tenofovir, an anti-viral already used to treat those with HIV infections. The gel has to be place within the vagina or rectum within 12 hours before and after sexual intercourse to be effective.
It was tested in South Africa, where infection rates are as high as 1 in 4 people. Those who conducted the trial are quick to label it a success even though, after a year long trial, it was only 39% effective.
Researchers were also quick to blame the participant women for not adhering to the instructions strictly enough and thereby lowering the effectiveness of the microbicide.
The Problems
Which is all well and good, but let’s be serious. Most drugs have a difference between that ideal “perfect usage” and the typical results we actually see in the real world. During the study they had their patients check in every day. If they can’t ensure perfect use now, there’s no way it’s going to happen once the drug is officially on the market.
Which brings me to another point, one reason this gel is being so hyped is the fact that it is cheap, apparently just a few cents per dose. Of course that’s before they attempt to put a retail mark-up on it.
Poverty is one of the biggest issues when it comes to the HIV epidemic. Even if each application only cost $0.03 to produce, it must be used twice for every instance of intercourse. Meaning it’s manufacturing is not cheaper than other methods, specifically condoms.
Condoms, according to a Georgia latex company, cost about $0.05 to $0.07 each to manufacture. Price wise this product is not going to be any more available. Plus the condom is more than twice as effective at preventing HIV transmission.
There is also talk of increasing circumcision rates to decrease transmission rates. Of course forty boys recently died due to circumcisions in South Africa. Poor hygiene and lack of access to medical care have the possibility to make this particularly dangerous, even regardless of the ethical issues. Of course it will be cheaper in the long run, but is still not as effective as a condom, and it won’t protect you from any other sexually transmitted infections either.
A Complete Approach
It often seems to me that they are trying to fix a leaky pipe with a bandaid. Patchy, quick fixes when the truth is we need to replace the system.
First is poverty, having a series of products that need to be paid for are meaningless if people can barely afford or not able to afford to feed and home themselves. Many of the countries themselves, strongly affected by the AIDS crisis, are deeply in debt.
Next is education. In many poorer countries, education itself is a luxury, but even in more well of countries, such as South Africa, a quality sex education is in question. Problems with poorly trained teachers and a high drop out rates lead to an education gap.
Finally, but just as important, we need to change social values. Violence against women is rampant in these countries. South Africa has the highest reported sexual assault rate in the world. They rank first in rapes per capita, it is certainly a dubious title. In other countries such as Zimbabwe or Swaziland, social structures both encourage polygamy or polyamory among men and yet pressure women not to request sexual protection such as condoms.
Many medical researchers are trying to find a magic bullet for the HIV crisis, but what it needs is an arsenal.
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