Bridget Haire The International Microbicides Conference Interview

Bridget Haire The International Microbicides Conference Interview

World leading HIV experts will soon be convening in Sydney to advance a new type of product that could change the face of HIV prevention: microbicides. The 2012 International Microbicides Conference (M2012) - From Discovery to Delivery - will take place from April 15-18 at the Sydney Exhibition and Conference Centre at Darling Harbour.
www.microbicides2012.org

Interview with Bridget Haire

Question: Please introduce yourself:

Bridget Haire: My name is Bridget Haire and I am an HIV prevention advocate. I am the senior policy analyst at Family Planning NSW and am also in the process of completing a PhD at the Centre for Values, Ethics and the Law in Medicine (University of Sydney) on HIV prevention trials. My role in the M2012 Conference is Community Chair.


Question: What are microbicides?

Bridget Haire: Microbicides are agents applied topically - into the vagina or rectum - to prevent particular infections like HIV or other sexually transmissible infections. As yet, there are no microbicides licensed for use, but there are several in development and one has shown some efficacy against HIV and HSV (herpes simplex virus) in a large-scale human trial.


Question: Can you talk about the importance of microbicides?

Bridget Haire: Microbicides are intended to empower women (and men who have receptive anal sex) to protect their sexual health if their partner can't or won't use a condom. At the moment, condoms are the only way to protect yourself against HIV and other STIs when having penetrative sex, whereas with contraception, you have options: the pill in various formulations, contraceptive injections, implants like Implanon, intra-uterine devices, intra-vaginal rings, diaphragms and of course condoms. The variety of contraceptive options has been developed because one size does not fit all - different women find different products to suit them. Similarly with HIV and STI prevention, having different options like microbicides is important.


Question: How do microbicides aid the prevention of sexually transmitted infections?

Bridget Haire: Prevention of HIV is the primary target for microbicides right now, though some protection against genital herpes was a welcome added effect of one particular microbicide in a large-scale human trial. The current batch of microbicides use antiretroviral drugs - the drugs used to treat HIV- to prevent the virus from replicating itself thus stopping infection from taking hold in the body. When used in the vagina, the activity of the drugs is localised, right where you need it to stop infection.


Question: How does the importance of microbicides differ all around the world?

Bridget Haire: In any context where a woman faces a risk of HIV acquisition, and can't get her partner to use a condom, microbicides are extremely important.

Young women in sub-Saharan African face the highest risk of acquiring HIV of any population in the world. A product that a woman controls herself enables her to protect herself even if her partner can't or won't use a condom. Microbicides also have the added advantage of not needing to be used right at the moment of having sex, so a woman can plan ahead and squirt the microbicide into her vagina 'just-in-case'. Closer to home, Papua New Guinea has a generalised heterosexual HIV epidemic, so microbicides will be very valuable for women there too.


Question: Can you talk about the importance of microbicides for Australians?

Bridget Haire: Microbicides will probably have the greatest application in Australia for STI prevention rather than HIV prevention, as we do not have a large HIV heterosexual population. That said, there are couples where the man has HIV and the women does not, and they will probably embrace an HIV prevention method that allows for more intimacy than condoms. Gay couples will also benefit when there is a microbicide proven safe and effective for rectal use.


Question: Does the importance differ in regards to male and female?

Bridget Haire: In my view, what's good for women is good for men, as empowering women builds a fairer world for all.

Currently there are no proven 'bidirectional' microbicides - microbicides that a positive woman could use to prevent infecting her partner, but there will be research into this. Microbicides are also being tested for rectal use so that men (and women!) who have anal sex will have another prevention option. The rectal environment is more fragile than the vagina (more easily irritated and damaged), so rectal products are a little further away.


Question: Can you talk about the future, in regards to the development and use of microbicides?

Bridget Haire: A microbicide product that works, is safe, and is cheap enough for the people who need it to get enough of it must be a global priority. We have evidence about one product, but are awaiting the results of a larger confirmatory trial before that product is licensed for use. We are also seeing innovation in the way that microbicides are delivered, for example through drug-dispensing vaginal rings that would be put in place and then changed once a month. These new developing technologies offer a great way of ensuring that the product is in place when it needs to be.


Question: Why was it important to you to take part in The 2012 International Microbicides Conference?

Bridget Haire: This conference brings together the scientists who develop and test products with the communities who want and need these products, and who are working towards making user-friendly and women-friendly HIV prevention options a reality despite the massive challenges involved. It is a privilege to be part of this important work.


Question: What will you be speaking about at The International Microbicides Conference?
Bridget Haire: I will be speaking about how trials of new HIV prevention technologies operate and consider ways of addressing some of the challenges ahead.


Interview by Brooke Hunter