Microbicides 2004 Microbicides 200428-31 March 2004, Hilton London MetropoleThe conference42 million men, women and children worldwide were living with HIV by the end of December 2002 (source: UNAIDS), including five million newly-infected during that year alone. Another 45 million people will become infected between 2002 and 2010, unless the current transmission rates can be vastly reduced. Of the 42 million, 29.4 million live in sub-Saharan Africa and 58% of them are women. Not only are women more susceptible to HIV infection, many are powerless to insist on the use of condoms or other methods of protecting themselves. In this context, and with the knowledge that an effective HIV vaccine is unlikely to be available for several years, the need for an effective topical microbicide grows ever more urgent. 2004 should prove to be a landmark year in the field of microbicide development as the first Phase III trials of novel products are due to start – the next step along the road to making a microbicide available to the millions worldwide in desperate need of protection.The aims of the Microbicides 2004 conference are to:Report novel or innovative work in the microbicides fieldProvide updates on recent microbicides research, divided into three tracks: basic science, clinical science, and behavioural science (including public health and the microbicide marketplace)Provide a forum for the discussion of new developments in microbicide research including ethical, clinical, behavioural and methodological issuesPresent opportunities for knowledge-sharing between microbicide researchers, public-health workers and advocacy organisations.There will be an opening ceremony on the evening of Sunday 28 March at which politicians, policy makers and the international media are expected. The conference will run for a full three days, each of which will contain:Scientific overviews and presentations with plenary sessions, invited lecturers and presentations of original researchWorkshops to review issues unique to microbicides such as trial design and outcome measures, and ethical issues in the clinical trials of microbicidesPoster sessions. Focus on LondonFollowing the successful Microbicides conferences in Washington in 2000 and Antwerp in 2002, March 2004 sees the focus move to London.The venue is the Hilton Metropole Hotel, two minutes by taxi from Paddington station and the Heathrow Express, with a journey time from the airport of 15 minutes. The hotel is in walking distance of Hyde Park and London’s main shopping streets, and close to Imperial College. Accommodation will be available at the venue and other hotels in the vicinity.London in March offers a variety of diversions for out-of-conference relaxation, including sight-seeing and shopping; the arts and the theatre; and pubs, clubs and restaurants to suit every taste. Conference staff will be on hand to help delegates plan their spare time.To book your place or find out more information, e-mail info@microbicides2004.org.uk or telephone the Event Office on +44 (0) 20 7720 4411
Oral: invited speaker Oral: Track A Oral: Track B Oral: Track C Poster: Track A Poster: Track B Poster: Track C Abstract only Authors

02590 HOW IMPORTANT IS THE STI EFFICACY OF A MICROBICIDE: MODEL PREDICTIONS FROM TWO SETTINGS

Vickerman, Peter*
Watts, C.* Foss, A. *, Alary, M.** Delany, S. ***, Rees, H.***, Heise, L.****
*LSHTM UK. **University of Laval, Canada. ***Rhru, South Africa. ****Path, USA.

Background: STIs are cofactors for HIV infection. However, the distribution of STIs varies from setting to setting and so the degree to which they drive different HIV epidemics must vary. The extent to which the efficacy of a microbicide against different STIs determines its impact on HIV transmission is investigated in Cotonou, Benin and Johannesburg, South Africa. The settings are different with respect to their underlying risk behaviour, and prevalence of STIs and HIV.
Methods: With data from each city, a mathematical model is used to estimate the amount STIs drive the HIV epidemic in each setting, and the impact of introducing microbicides with different HIV and STI efficacies. Model simulations are compared to determine how the STI efficacy of a microbicide affects the impact of the microbicide in settings with different STI distributions.

Results: The impact of introducing a microbicide in a specific setting is determined by the microbicides efficacy against HIV and other STI. The amount attributable to the STI efficacy of the microbicide depends on the distribution of STIs and the amount STIs drive the HIV epidemic.

Conclusions: A microbicide can reduce HIV transmission even if it is not efficacious against HIV. The impact of a microbicide with specific STI efficacy will vary depending on the setting. This highlights the importance of estimating the efficacy of microbicides against STIs other than HIV in intervention trials, so that unbiased estimates of HIV efficacy can be made and the impact of introducing it in different populations can be investigated realistically.

Dr Peter Vickerman
London School of Hygiene and Tropical Medicine, London, WC1E 7HT, UK
(Telephone) +44 (0)20 7612 7886 (Fax) +44 (0)20 76375391 (E-mail) peter.vickerman@lshtm.ac.uk