The International Rectal Microbicides Advocacy (IRMA) has launched a special report on rectal microbicides in Africa. Titled 'On the map: Ensuring Africa's place in rectal microbicide research and advocacy', this report was released at the International Microbicides Conference (M2012) in Sydney, Australia. A cornerstone of IRMA's Project ARM (Africa for Rectal Microbicides) initiative, the strategy document developed by African advocates, researchers, and global allies outlines priority actions to ensure Africa fully engages in rectal microbicide research and advocacy activities, including the integration of safe anal-sex messaging into HIV prevention programs.
"For far too long the operating principle concerning the HIV epidemic in Africa has been that it is solely heterosexual, and that sexual transmission is entirely driven by unprotected vaginal intercourse between men and women," said Jim Pickett, IRMA chair and Director of Advocacy, AIDS Foundation of Chicago. "But an increasing body of evidence tells us quite clearly that unprotected anal intercourse is happening all across the continent – amongst heterosexuals as well as gay men, other men who have sex with men (MSM), and transgender individuals. Unprotected anal intercourse is not uncommon in Africa," he continued, "and compared to unprotected vaginal intercourse, it is 10 to 20 times more likely to result in HIV infection. We absolutely need to be concerned about this."
"We still face significant hurdles regarding human rights for gay men, MSM, and transgender individuals in Africa, but the collective, long-term efforts of advocates and scientists are indeed lifting the denial around anal sex in the African context," said Morenike Ukpong, New HIV Vaccines and Microbicides Advocacy Society in Nigeria, IRMA member, and one of the chief architects of the Project ARM strategy. "Great efforts have long been underway to develop safe and effective vaginal microbicides for African women. We need the same level of commitment and resources for the development of safe, effective, acceptable and accessible rectal microbicides for Africans regardless of gender identity or sexual orientation."
"Our diverse sexualities in Africa shouldn't be defined only by the prevention tools we have available. HIV prevention tools must be adapted to our sexualities." – Alliance Nikuze, Rwanda, IRMA member, as quoted in the report.
'On the Map: Ensuring Africa's Place in Rectal Microbicide Research and Advocacy' is the result of an intensive two-day consultation conducted with over 40 Africans and allies that took place in Addis Ababa, Ethiopia in early December 2011. It calls for a set of activities related to research and community mobilization designed to fully engage Africans, including a Knowledge, Attitudes and Behaviours study on anal sex, advocacy for increased condom-compatible lubricant access, and communication and education activities.
Even as this report is being released, Africa has already made great strides in rectal microbicide research and advocacy. A global Phase II rectal microbicide trial looking at tenofovir gel in gay men and transgender women, planned by the Microbicide Trials Network (MTN), includes the Desmond Tutu HIV Foundation in Cape Town, South Africa as one of its clinical trial sites.
As IRMA member and Desmond Tutu research assistant Brian Kanyemba says in the report, "I am incredibly proud to say we will be the very first African trial site for a rectal microbicide study. I hope the field will conduct rectal microbicide research in other African countries as well as South Africa!"
"Africans need rectal microbicides and they need to be part of the advocacy, research and development processes that are essential to creating products that are not only safe and effective but acceptable and accessible too. I pledge our full support for the efforts of Project ARM." said Dr Ian McGowan, Microbicides Trials Network (MTN) co-principal investigator; IRMA Scientific Vice Chair; and Co-Chair of M2012.
Funding and in-kind support for the launch of Project ARM and the development of "On the Map: Ensuring Africa's Place in Rectal Microbicide Research and Advocacy" was provided by the National Institutes of Health – Office of AIDS Research, the New Venture Fund, AVAC, and AIDS Foundation of Chicago.