7 - Topical Microbicides

Abstract

The risk of becoming infected or infecting others with human immunodeficiency virus (HIV) substantially increases if a person has a sexually transmitted disease (STD), such as chancroid, genital herpes, syphilis, trichomoniasis, gonorrhea, or chlamydial infection. Effective female-controlled topical microbicides can be used to enhance the ability of women to avoid sexually transmitted infections. The topical microbicides are preparations for the intravaginal or intrarectal uses that are microbicidal and have the ability to prevent sexually transmitted infections. Classes of microbicidal compounds include detergents, defensins and other antimicrobial peptides, antibodies, organometallic complexes, and reverse transcriptase inhibitors. The development of safe and effective topical microbicides involves a broad-based research agenda that spans the basic biomedical and behavioral research, product development, and clinical/behavioral evaluation. They are evaluated through vitro systems, ex vivo systems, and animal models. The chemical barriers that inactivate pathogens in vaginal/cervical secretions, as well as in the ejaculate, reduce female-to-male and male-to-female transmissions.