Science magazine in its Aug 12 issue examined a number of HIV
prevention strategies currently under development that some say
should be given more resources than vaccine development. The
strategies include:

Circumcision: A recent study of 3,000 HIV-negative men in South
Africa found that circumcision can reduce by about 65% the risk of
men contracting HIV through sexual intercourse with women. Similar
circumcision studies are under way in Kenya and Uganda;

Treating Pre-Existing Herpes Infection: A study conducted about five
years ago in four African cities found that a pre-existing herpes
infection increased the risk of HIV transmission. Connie Celum with
the University of Washington in Seattle is leading two international
trials of acyclovir, which is used daily to treat herpes, to see
whether suppressing herpes can prevent HIV transmission. If the drug
works, it could affect the HIV/AIDS pandemic because more than 80% of
HIV-positive adults are co-infected with herpes;

Antiretroviral Drugs: Other prevention trials are focusing on whether
antiretrovirals might be helpful in preventing HIV transmission. The
HIV Prevention Trials Network, sponsored by NIH's National Institute
of Allergy and Infectious Diseases, recently launched a study of
antiretroviral treatment involving 1,750 couples worldwide;

Microbicides: Five efficacy trials of vaginal microbicides are
currently under way, and one study is examining microbicides that can
be placed in the rectum. Researchers also are looking into
incorporating antiretrovirals such as tenofovir into microbicides;

Early Detection: Scientists also are looking at ways to improve HIV
detection at early stages of infection, when the risk of transmission
is highest;

Diaphragms: Another study is looking at how the diaphragm and a
lubricant can help prevent HIV transmission. Nancy Padian with the
University of California-San Francisco, who is conducting studies of
the diaphragm in Zimbabwe and South Africa, said the device might
help prevent the virus from reaching the cervix and endocervix, where
most female infections occur;

Gels: Other scientists are conducting a study in Kenya to discover
whether wiping the penis with an ethanol-based gel can prevent
transmission of HIV, herpes and other sexually transmitted diseases;

Antidepressants: A researcher in San Francisco will launch a study
this fall that will evaluate the impact of antidepressants on HIV
transmission. Previous studies have indicated a connection between
depression in men who have sex with men and risky sexual behavior
(Cohen, Science, 8/12).

Source: http://www.kaisernetwork.org