Tuesday, 28 October 2014

No, this is not Sexpo

LIZ MCGREGOR writes: There is lots of talk about sex at the Cape Town Convention Centre at the moment: words like anal sex; vaginas and penises are constantly popping up. No, this is not the Sexpo – it is HIV R4P, the archly-named international conference on biomedical methods of protecting ourselves against getting infected with HIV.

It is wonderfully non-judgemental – who you choose to have sex with, how often and in what manner – is totally irrelevant. The only subject of interest is how you stop a virus from destroying a human body.

The consequences for the intimate and emotional aspects of sex have not been entirely overlooked. As one of the many leading scientists here, Jared Baeten, professor of global health, medicine and epidemiology at the University of Washington, remarked: "We must remember that sex is not just a clinical activity. There is a whole generation which has grown up knowing only fear in relation to sex."

But, with more than two million people becoming newly infected last year, we need to throw everything at the virus.

At the ICC this week, four scientific prevention methods are under the spotlight – none are fail-safe and some are still nowhere near ready for universal use.

Medical male circumcision is the most accessible: it has been proven that a man who is circumcised reducing his risk of getting HIV from an infected partner by at least 60%.

Vaccines are still the holy grail and we are inching closer to finding one that works but we’re not there yet.

Another option being tried is Pre-exposure Prophylaxis: this means someone who is not HIV positive but is at risk takes anti-retrovirals as precaution. It is suggested it is used by an HIV-negative person if their sexual partner is HIV positive. Or in high risk groups – like the receptive partner in men who have penetrative sex with men. But obviously it is difficult to persuade someone who is not sick to take drugs which are potentially toxic. And it is very expensive as a public health option.

Treatment as prevention does work, however, when taken by an HIV-positive person, as it reduces his or her viral load and thus makes them far less likely to infect a partner.

The most promising option is microbicides, which are inserted into the vagina or rectum before and/or after sex. The results of a big study carried out in Cape Town are due early year and, so far, it is looking very hopeful.

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