The World AIDS Conference is in full swing in Vienna, Austria this week, with the leading researchers in HIV/AIDS gathered to present their most recent research. We spoke yesterday with our esteemed HIV/AIDS expert, Dr. Raphael Landovitz, MD, Assistant Professor in the Division of Infectious Diseases at the Center for Clinical AIDS Research & Education at the University of California, Los Angeles, who is at the conference. We asked him about the findings being presented there, and where the next developments in HIV/AIDS research are likely to appear.

The highlight of the week was a study called CAPRISA 004 (CAPRISA stands for Center for the AIDS Program of Research in South Africa), which tested an antimicrobial gel containing an antiretroviral medication called tenofovir. Says Dr. Landovitz, "This study was conducted at two sites in South Africa, one urban and one rural. It followed 889 women in a placebo-controlled, randomized trial, meaning that the women were randomly assigned to receive either the tenofovir gel or a placebo. They received montly HIV testing and sexual risk-reduction counseling. They were instructed to use the gel within 12 hours of anticipating having sex, then as soon as possible within 12 hours after having sex.

After 30 months, the researchers found that there was an overall 39% reduction in HIV transmission, which was highly satistically significant." And, Dr. Landovitz tells us, in the people who adhered most closely to the protocol, and used the gel with the greatest regularity, the effect was even higher. "In people who used it at least 80% of the time," Dr. Landovitz says, "the gel was 54% effective. This suggests that perhaps with better adherence you could get even greater results—and it’s probably not reasonable to expect a product to provide protection if you don’t use it."

The study had a second very promising finding: "In addition, there was an unexpected finding of a 50% protection against Herpes type 2, or HSV-2. This is important because people who have HSV-2 double the risk of acquiring HIV infection; because it causes “ulcers,” or breaks in the genital lining, it compromises the body's natural defenses, making HIV infection more likely. So if we can prevent HSV-2, we may get even better HIV prevention. In fact, this suggests that the 30-month result may actually be an underestimate of what is possible from the combination of HIV prevention immediately, and longer term HIV protection which not having HSV-2 confers.”

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