| CTH4a | |
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| Dobromir Dimitrov |
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| Fred Hutchinson Cancer Research Center |
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| Title | Modeling the Gender-Specific Benefits of Wide-Scale Microbicide Interventions |
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| Abstract | Vaginal microbicides (VMB) are currently among the few promising biomedical interventions candidates for preventing heterosexual transmission of HIV. More than 40 products have been tested in clinical trials and some of them have already produced encouraging results in reducing susceptibility of their users. However, there are concerns that the next generation of microbicide containing ARV (ARV-VMB) may lead to the development of antiretroviral resistance and could paradoxically become more beneficial to men at the population-level. We develop and analyze deterministic models of HIV transmission to study the public health impact of a VMB intervention in a sexually heterogeneous population. We formulate indicators to evaluate population-level benefits and to quantify the likelihood of male or female advantage in the benefits of a intervention under a wide array of utilization. We investigate the influence of different factors such as VMB efficacy, transmission probabilities, and rates of development of resistance on benefit distribution between sexes. Our analysis shows that VMB is very much a female prevention tool. The likelihood of male advantage in benefits is substantial only if the risk of systemic absorption of the product is high and the HIV-positive women remain on VMB indefinitely. Successful control measures that restrict VMB-usage by HIV-positive women reduce the risk of resistance development and further increase the likelihood of female advantage in prevented infections. |
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| Coauthors | Ben Masse, Marie-Claude Boily |
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| Location | Woodward 4 |
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