Prophylactic contraceptives for HIV/AIDS

The current pandemic of sexually transmitted human immunodeficiency virus ( HIV) infection-the causative agent of acquired immunodeficiency syndrome(AI DS), has created an urgent need for a new type of contraceptive: one that i s both a spermicide and a microbicide, Because most women at risk for HIV i nfection are of reproductive age (15-44 years), effective use of dual-funct ion contraceptives is important to prevent HIV transmission and unintended pregnancies, In the absence of an effective prophylactic anti-HIV therapy o r vaccine? new emphasis has been placed on the development of intravaginal microbicidal agents capable of reducing the transmission of HIV. Topical mi crobicidal spermicides would ideally provide a female-controlled method of self-protection against HIV as well as presenting pregnancy. However, sever al microbicides that are undergoing preclinical and human clinical trials c ontain detergent-type ingredients. The detergent-ta pe spermicide, nonoxyno l-9, the only recommended microbicide for protection against sexual transmi ssion of HIV has been shown to cause lesions in vaginal and cervical epithe lia leaving women mote vulnerable to HIV infection. Therefore, a major chal lenge in microbicide research has been to design mechanism-based microbicid es that are highly effective against pregnancy and HIV transmission while l acking detergent-type effects on epithelial cells and normal vaginal flora. We present an overview of current microbicide research and report on the i dentification and preclinical development of novel non-detergent spermicida l nucleoside and non-nucleoside inhibitors aimed at decreasing pregnancy an d preventing sexual transmission of HIV.