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Female Genital Tract Secretions and Semen Impact the Development of Microbicides for the Prevention of HIV and Other Sexually Transmitted Infections
Author(s) -
Herold Betsy C.,
Mesquita Pedro M.,
Madan Rebecca P.,
Keller Marla J.
Publication year - 2011
Publication title -
american journal of reproductive immunology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.071
H-Index - 97
eISSN - 1600-0897
pISSN - 1046-7408
DOI - 10.1111/j.1600-0897.2010.00932.x
Subject(s) - microbicide , microbicides for sexually transmitted diseases , vaginal microbicide , medicine , semen , immunology , human immunodeficiency virus (hiv) , vagina , clinical trial , population , andrology , environmental health , surgery , health services
Citation
Herold BC, Mesquita PM, Madan RP, Keller MJ. Female genital tract secretions and semen impact the development of microbicides for the prevention of human immunodeficiency virus (HIV) and other sexually transmitted infections. Am J Reprod Immunol 2011; 65: 325–333 Pharmacologic strategies for the prevention of HIV include vaccines, post‐exposure prophylaxis with antiretroviral therapy, and topical microbicides. Vaginal microbicides have the potential to augment innate defenses in the genital tract but may also disrupt endogenous protection and increase HIV acquisition risk, as observed in clinical trials of nonoxynol‐9. The initially disappointing results of microbicide clinical trials stimulated the development of more sensitive and comprehensive pre‐clinical safety studies, which include dual‐chamber culture systems to model the epithelial barrier and post‐coital studies to evaluate the effects of semen and sexual intercourse on microbicide efficacy. This review discusses the key factors that contribute to a healthy female genital tract environment, the impact of semen on mucosal defense, and how our understanding of these mediators informs the development of effective vaginal microbicides.