Another Defense for Women

Microbicides might have another role in fighting HIV infection, if they can be used to treat genital tract infections such as bacterial vaginosis. That's a possibility being explored by Taha Taha, MBBS, PhD '92, MPH, Epidemiology professor and co-director of Infectious Disease Epidemiology.

Bacterial vaginosis is a change in the normal balance of bacteria in the vaginal tract, and is fairly common. It is also associated with HIV infection, although whether it actually increases the risk is still not clear. But it's possible that treating bacterial vaginosis might also reduce the risk of HIV infection in women.

A common treatment for bacterial vaginosis is an oral antibiotic called metronidazole. Taha decided to see if intermittent intravaginal applications of a metronidazole gel for five consecutive nights every three months could reduce rates of bacterial vaginosis.

A trial in Malawi involving 1,686 women randomly assigned either to an intravaginal antibiotic gel or placebo gel demonstrated mixed results. Both gels reduced bacterial vaginosis in both HIV-positive and HIV-negative women, but they did not prevent the infections from recurring.

Nevertheless, Taha says the study shows that intermittent intravaginal gel treatments can have some effect, and he is continuing to study the approach in other microbicide trials using other products.