{{short description|Microbicide for vaginal use}} {{Infobox medical intervention | name = Vaginal microbicide | synonym = | image = | caption = | alt = | pronounce = | specialty = Gynecology | synonyms = | ICD10 = | ICD9 = | ICD9unlinked = | CPT = | MeshID = | LOINC = | other_codes = | MedlinePlus = | eMedicine = }}A '''vaginal microbicide''' is a microbicide for vaginal use, generally as protection against the contraction of a sexually transmitted infection during vaginal sexual intercourse. Vaginal microbicides are topical gels or creams inserted into the vagina.
== Target market == Researchers have investigated who has interest in using a vaginal microbicide. Condoms are highly effective in preventing the transmission of infection, but worldwide, the decision to use condoms is more often a decision made by males than females.<ref name="Development"/> A vaginal microbicide which could prevent sexual transmission of infection would further empower women to influence the result of their sexual encounters.<ref name="Development"/> The demographic interested in using the produce included women with the following characteristics:<ref name="interest">{{cite journal|last=Darroch|first=Jacqueline E.|author2=Jennifer J. Frost |title=Women's Interest in Vaginal Microbicides|journal=Family Planning Perspectives|date=January–February 1998|volume=31|issue=1|url=http://www.guttmacher.org/pubs/journals/3101699.html|access-date=21 November 2011|doi=10.2307/2991552|pmid=10029928|pages=16–23|jstor=2991552|url-access=subscription}}</ref>
{{div col}}* use condoms to prevent infection * have previously had a sexually transmitted infection * have a sexual partner who had another sexual partner in the past year * minority group * low income * unmarried and not cohabiting * no steady sexual partner {{div col end}}
The number of women interested in using such a product has been characterized as being significant enough to merit product development and marketing.<ref name="interest"/>
===Characteristics=== The ideal vaginal microbicide would have the following characteristics: provide protection against infection not require application at the time of intercourse not harm the natural tissue<ref name="amfarpromise">{{cite web |last1=Laurence |first1=Jeffery |last2=Johnston |first2=Rowena |date=19 February 2009 |title=The Promise of an Effective Vaginal Microbicide |url=http://www.amfar.org/lab/article.aspx?id=6324 |archive-url=https://web.archive.org/web/20110323033340/http://www.amfar.org/lab/article.aspx?id=6324 |archive-date=23 March 2011 |access-date=20 November 2011 |work=amfar.org}}</ref> {{As of|2009}}, not harming natural tissue was the most troublesome aspect of development.<ref name="amfarpromise" />
==For HIV== Studies for using vaginal microbicides for HIV treatment rapidly increased through 2011 to 2013 due mostly to the observation that antiretroviral drugs designed for HIV treatment sometimes also achieve preexposure prophylaxis and significantly reduced HIV risks.<ref name=":0">{{Cite journal |last1=Stone |first1=Alan B. |last2=Harrison |first2=Polly F. |last3=Lusti-Narasimhan |first3=Manjula |date=2013-09-10 |title=Microbicides from a regulatory perspective |journal=AIDS |language=en-US |volume=27 |issue=14 |pages=2261–2269 |doi=10.1097/QAD.0b013e32836239b4 |issn=0269-9370|doi-access=free |pmid=23612007 }}</ref> Several unrelated chemical mechanisms have been proposed for vaginal microbicides treating HIV.<ref name="Development">{{Cite journal | last1 = Weber | first1 = J. | last2 = Desai | first2 = K. | last3 = Darbyshire | first3 = J. | author4 = Microbicides Development Programme | title = The Development of Vaginal Microbicides for the Prevention of HIV Transmission | doi = 10.1371/journal.pmed.0020142 | journal = PLOS Medicine | volume = 2 | issue = 5 | pages = e142 | year = 2005 | pmid = 15916473| pmc =1140953 | doi-access = free }}</ref> One obstacle to effective research is that trials may involve social harms for trial participants, although one 2019 study found these social harms to be relatively small.<ref>{{Cite journal |last1=Montgomery |first1=Elizabeth T. |last2=Roberts |first2=Sarah T. |last3=Nel |first3=Annalene |last4=Malherbe |first4=Mariette |last5=Torjesen |first5=Kristine |last6=Bunge |first6=Katherine |last7=Singh |first7=Devika |last8=Baeten |first8=Jared M. |last9=Marrazzo |first9=Jeanne |last10=Chirenje |first10=Z. Mike |last11=Kabwigu |first11=Samuel |last12=Beigi |first12=Richard |last13=Riddler |first13=Sharon A. |last14=Gaffour |first14=Zakir |last15=Reddy |first15=Krishnaveni |date=2019-11-15 |title=Social harms in female-initiated HIV prevention method research: state of the evidence |journal=AIDS |language=en-US |volume=33 |issue=14 |pages=2237–2244 |doi=10.1097/QAD.0000000000002346 |issn=0269-9370|doi-access=free |pmid=31408030 |pmc=6832829 }}</ref> There is also often a self-reporting bias in condom and vaginal microbicide use in trials, suggesting the need for vaginal applicator staining to confirm whether the vaginal microbicides were effectively applied.<ref>{{Cite journal |last1=Mauck |first1=Christine K. |last2=Schwartz |first2=Jill L. |date=2012 |title=Dyeing to Know: The Use of Vaginal Applicator Staining and Other Techniques to Assess Adherence to Product Use in Microbicide Trials |url=https://www.jstor.org/stable/44981930 |journal=Sexually Transmitted Diseases |volume=39 |issue=9 |pages=713–715 |doi=10.1097/OLQ.0b013e318264f6b0 |jstor=44981930 |pmid=22902668 |issn=0148-5717}}</ref>
===Surfactants=== The first vaginal microbicide studied was nonoxynol-9, which acted as a surfactant.<ref name="Development"/>
===Blocking HIV binding=== PRO 2000, carrageenan, and cellulose sulphate have been studied as microbicides to block HIV binding.<ref name="Development"/>
===Topical antiretrovirals=== Tenofovir has been studied as a topical antiretroviral.<ref name="Development"/> One example of a tenofovir study is CAPRISA 004 in 2010, finding its use reduced HIV infection risk by 39% overall.<ref name=":0" />
== See also ==
* Rectal microbicide * Microbicides for sexually transmitted diseases
==References== {{reflist}}
==External links== * [https://dvhc.org/maintaining-healthy-vagina/ Tips to Maintaining a Healthy Vagina]
{{Microbicides for sexually transmitted diseases}}
Category:Microbicides Category:Prevention of HIV/AIDS Category:Sexually transmitted infections Category:Vagina