NEW HIV infections in South Africa could be almost eliminated by combining prevention tools that have been proven to reduce transmission, an expert on the virus told a conference in the US yesterday. Dr Susan Buchbinder said scientific trials had shown that medical male circumcision, condoms and the prevention-of-mother-to-child therapies lowered the risk of infection. In South Africa an estimated 1 600 people a day are infected with HIV. But microbicides have not yet been shown to block the virus. For this reason, the 1000 delegates at the M2010 Microbicides conference in Pittsburgh, US, are eagerly waiting for the results - to be released in July - of the first human clinical trial to test an antiretroviral drug-based microbicide. The microbicide has been tested in a study led by University of KwaZulu-Natal Professor Salim Abdool Karim. Another prevention strategy being tested in South Africa is PrEP (pre-exposure prophylaxis), in which HIV-negative people take antiretrovirals to stop infection. Mitchell Warren, executive director of global advocacy organisation AVAC, said not only was South Africa at the forefront of testing individual approaches but it was leading the development of combination prevention, which was clearly the only way to truly end the epidemic. Three microbicide and PrEP trials are under way at sites across South Africa, another is taking place among couples in which one partner is positive and the other negative, and the country has been involved in vaccine trials.

Claire Keeton: The Times, 26 May 2010