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Research and clinical trials in HIV/AIDS
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You can learn more about participating in clinical trials from the NIH
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Did you know?
Studies suggest that circumcision
might help prevent the spread of HIV. But it has only proven effective at lowering a man's risk of getting HIV
through vaginal sex with a woman who is infected. It is also possible that circumcision could reduce male to female transmission of HIV. More research is needed to see how circumcision may help prevent HIV.
Research helps us better understand HIV/AIDS, how it affects the body, and how to prevent and treat infection. To support this work, the National Institutes of Health (NIH) heads up the largest HIV/AIDS research program in the world. Because HIV involves so many parts of the body, HIV/AIDS research is conducted and supported by most of the 27 NIH institutes and centers. The work is coordinated by the Office of AIDS Research in the Office of the Director of the NIH. The NIH has programs to speed up the review of all grant applications for HIV/AIDS-related research. Here are some of the research programs NIH is involved in, as well as the aspects of HIV/AIDS care and prevention that are being studied:
The Women's Interagency HIV Study, started in 1993, is designed to investigate the history and course of HIV infection in women. This nationwide study tracks 3,000 HIV-positive women and 1,000 women without HIV but at high risk of getting the virus. About 80 percent of those in the study are minority women. Several findings from the study are listed below.
- The more children an HIV-positive woman has living at home, the less likely she is to follow her HIV treatment plan compared to childless women with HIV.
- Women infected with HIV have a higher waist-to-hip ratio but lower body mass index (BMI) and smaller waist size than women who do not have HIV. Whether these findings affect heart disease risk is still not known. In general, carrying excess weight around the middle increases a woman's heart disease risk, while a lower BMI lowers heart disease risk. Find out your BMI.
- Depression leads to lower T-cells and greater risk of death in HIV-positive women. These findings point to depression as a risk factor for death for HIV-positive people, both male and female.
- HIV-positive women experience opportunistic infections at higher CD4 counts and lower viral loads than in men.
- Active drug users who were HIV-positive had a higher rate of death from non-HIV causes. These included deaths from liver failure, murder, suicide, and overdose on illicit drugs.
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Many areas of HIV/AIDS research involve clinical trials. Clinical trials are research studies designed to find out if new drugs, vaccines, or other treatments are safe and if they work in people. Sometimes, it can be hard for patients to learn about opportunities to take part in clinical trials. You can find HIV/AIDS clinical trials at the National Institutes of Health (NIH). You can also call the Vaccine Research Center of the NIH at 866-833-5433.Doctors and patient advocacy groups can also be great resources.
Newspapers, particularly in large cities, often carry clinical trial recruitment advertisements. You can also call a nearby university hospital medical center for more information. If you decide to take part in a clinical study, see these frequently asked questions about clinical studies. Below are four popular HIV/AIDS clinical trial groups.
- Adult AIDS Clinical Trials Group (ACTG) – ACTG is the largest HIV clinical trials organization in the world. It plays a major role in setting standards of care for HIV infection and opportunistic infections related to HIV/AIDS.
- International Maternal Pediatric Adolescent AIDS Clinical Trials Group (IMPAACT) – IMPAACT works to evaluate treatment for HIV-infected infants, children, adolescents, and pregnant women. It works to develop safe and effective ways to prevent passing HIV from mother to child. It also looks at the safety and efficacy of HIV vaccines that are in development.
- Community Programs for Clinical Research on AIDS (CPCRA) – The CPCRA is a clinical trials program that conducts research where people get basic health care. The research sites have enrolled more than 35,000 HIV-infected individuals in 47 clinical trials. Participating sites include private physicians' practices, public hospital clinics, freestanding community clinics, university and veterans' hospital clinics, and drug-treatment facilities. The results of CPCRA studies have significantly improved the care of people with HIV disease and AIDS.
- HIV Prevention Trials Network (HPTN) – This global research network works to find medicines that can prevent HIV, including topical microbicides. Research through the HPTN is carried out at sites in the United States, as well as overseas in Africa, Asia, Europe, and South America.
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A topical microbicide (meye-KROH-buh-syd) is a gel, cream, or foam that is applied in the vagina or rectum before sex to prevent HIV and other sexually transmitted infections (STIs). Research findings show that a microbicide gel containing the antiretroviral drug tenofovir can help to prevent HIV infection in some women. More studies are needed, but this finding could lead in time to an easy-to-use and inexpensive product that lowers a woman's risk of getting HIV from sex. Microbicides will offer women an HIV prevention method that they can control.
NIH supports a wide variety of topical microbicide research programs. Products undergoing research may work by:
- Killing or inactivating pathogens
- Strengthening the body's normal defenses
- Blocking attachment of HIV to at-risk cells
- Stopping viral spread from the first cells that acquire HIV to other cells in the body
In one recent study, women in South Africa who used an experimental microbicide 12 hours before and 12 hours after sex were almost 40 percent less likely to get HIV than women who did not use it. However, more research needs to be done before microbicides would become available to all women.
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Research has been looking into how people who are at high risk of HIV can prevent HIV by taking medicine before coming in contact with the virus. This is called pre-exposure prophylaxis (PrEP). The HIV drug Truvada has been proven to reduce the risk of HIV in men who have sex with men. It is only recommended as a PrEP treatment in this group of men. Although a recent study showed that the drug was not effective in women, more information needs to be gathered to make sure. Other studies using this drug to prevent HIV in women are underway. You can read the Centers for Disease Control and Prevention's guidance on who should use PrEP for HIV prevention, and when.
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Defeating HIV/AIDS will be hard — if not impossible — without a safe and effective vaccine. So, vaccine research has been and continues to be a top priority for NIH. Two different types of vaccines are being explored:
- Preventive vaccines are for people who are HIV-negative; they would be used to protect people from becoming infected with HIV.
- Therapeutic vaccines are for people who are HIV-positive; they would strengthen the immune system to prevent the progression of HIV to AIDS.
The development of an HIV vaccine is many years away. This is because developing an HIV vaccine is a complex research challenge. Presently, the focus of vaccine research is on developing a basic understanding of HIV and how humans respond to the virus. Both HIV-positive and HIV-negative volunteers are needed to advance vaccine research efforts. To learn how you can get involved, select a trial site in a city near you and contact the site recruiter or community educator. Or, contact the Vaccine Research Center at NIH.
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More information on Research and clinical trials in HIV/AIDS
Explore other publications and websites
About Microbicides (Copyright © Global Campaign for Microbicides) - This publication discusses the possible use of microbicides to prevent HIV and other sexually transmitted infections.
Clinical Trials of Medical Treatments: Why Volunteer? - This publication encourages people, including minorities and women, to participate in clinical trials and explains the benefits of doing so.
ClinicalTrials.gov - This website provides regularly updated information about federally and privately supported clinical research. It also gives information about a trial’s purpose, participants, location, and contact information.
HIV/AIDS Vaccines - This website provides a comprehensive overview of HIV/AIDS vaccine research and development.
Topical Microbicides - This report gives information about ongoing microbicide research.
Vaccine Development - This online publication provides an overview of efforts to produce an HIV vaccine.
VRC Vaccine Research Studies - Healthy people are needed to help researchers evaluate vaccines against diseases, such as HIV/AIDS. This publication provides steps for how you can participate in a vaccine research study.
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Content last updated July 01, 2011.
Resources last updated July 01, 2011.
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