"The Rectal Revolution Is Here": Getting to the Bottom of Rectal Microbicides

Published: February 11, 2013

If condoms are over 90 percent effective, when used constantly and consistently, in preventing the spread of HIV, then why do we need more options in our prevention toolbox? Why aren’t condoms working? This very blunt question was asked by Jim Pickett, chair of the International Rectal Microbicide Advocates (IRMA), to audience members at a discussion and video presentation entitled "The Bottom Line on Rectal Microbicide Research." Hosted by Gay Men’s Health Crisis (GMHC) on January 23, 2013, the presentation dealt with what will someday be a tool in that prevention toolbox, though it is currently only in trial phases — rectal microbicides.

A microbicide is a product applied topically in the vagina or rectum that can offer protection against HIV and other sexually transmitted infections (STIs), and can potentially be used for contraception. It would be available as a gel, lubricant, douche, or an enema and would provide protection in the absence of condoms or used together with a condom. This presentation focused almost exclusively on rectal microbicides and how they can be used as a prevention method among gay men to stop the spread of HIV and other STIs — and when it comes to advocacy in this growing field, Pickett is one of the world’s top minds.

IRMA was founded in 2005 by four people from four agencies in the United States and Canada. It is currently comprised of around 1,200 advocates, scientists, funders and policymakers. Their mission is to support the development and research of safe, effective rectal microbicides for all that need them. They work primarily to increase and diversify funding (currently, 97 percent of funding comes from the federal government), increase research activities, make lubricants safer (Pickett noted that, currently, the FDA approves lube without human trials and is often tested in rabbit and guinea pig genitalia only), increase access to lubricants, and increasing knowledge around lubricants and their uses.

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