A study published in the December issue of The Lancet reports on a three-year trial of Carraguard gel for HIV prevention and found that the microbicide, developed by the Population Council and derived from seaweed, is no better than a placebo at reducing HIV infections.
The researchers enrolled more than 6,000 sexually-active, HIV-negative women aged 16 years and older from three South African sites. The women were randomized to receive either the Carraguard gel and condoms or a placebo gel and condoms for use in vaginal intercourse, and were followed until they became pregnant or tested positive for HIV (up to two years). Clinical follow-up sessions each included counseling on HIV risk reduction and family planning for both groups.
There were no significant differences in time to HIV infection between the two groups, indicating that Carraguard did not work any better than a placebo. Carraguard was also about the same as placebo in terms of adverse effects.
A commentary in the same issue notes that this finding “continue[s] the discouraging wake of other coitally related topical products,” such as nonoxynol 9, cellulose sulfate, and the SAVVY gel. Researchers have focused on these insertable products as potential female-controlled methods of HIV prevention. Scientific American has a good, recent summary of the current state of this research. OBOS also provides companion content on microbicides.
PS: In another article in the current issue of The Lancet, I learned that the UK’s National Health Service is working on a “a guidance document designed to ensure that goods purchased for use in the NHS are manufactured ethically,” meaning adherence to basic international labor standards and workers paid a living wage. According to the article, the guidance document would inform the spending of £20 billion a year in NHS contracts, but would need adoption by the NHS Trusts to have the most impact.