The paradoxical effects of using antiretroviral-based microbicides to control HIV epidemics.

ABSTRACT: Vaginal microbicides, designed to prevent HIV infection in women, are one of the most promising biomedical interventions. Clinical trials of second-generation microbicides have begun; if shown to be effective, they could be licensed within 5-10 years. Because these microbicides contain antiretrovirals (ARVs), they could be highly effective. However, there is concern that, if used by HIV-positive women, ARV resistance may evolve. By analyzing a mathematical model, we find that adherence could have both beneficial and detrimental effects on trial outcomes. Most importantly, we show that planned trial designs could mask resistance risks and therefore enable high-risk microbicides to pass clinical testing. We then parameterize a transmission model using epidemiological, clinical, and behaviora

SUBMITTER: Wilson DP 

PROVIDER: S-EPMC2447864 | biostudies-literature | 2008 Jul

REPOSITORIES: biostudies-literature