17th April saw the launch of the report: On the Map: Assuring Africa’s Place in Rectal Microbicide Research and Advocacy by the International Rectal Microbicide Advocates (IRMA) On the Map: Ensuring Africa’s Place in Rectal Microbicide Research and Advocacy . The report has been developed by African advocates and researchers on the basis of an IRMA consultation held in Addis Ababa in December 2011. The report promotes initiatives to prepare for deployment of rectal microbicides (RM) in Africa, following successful completion of a Phase I trial of tenofovir-based RM in 2011 (MTN-007), and prior to the first Phase II trial (MTN-017), based in South African among other places.
In recent years a neglected epidemic among men who have sex with men (MSM) has been recognized in many low- and middle-resource settings where the predominant mode of transmission is heterosexual (J. Sanchez, STI 2011:87:Suppl.1). http://sti.bmj.com/content/87/Suppl_1/A7.2.abstract?sid=0dfd7f4e-457a-4935-ae85-9f1a939b9881 The activities envisaged by the IRMA report, including research, advocacy and communication, reflect the growing interest in the possibilities of RM as a means of HIV prevention. M. Meyer, writing for STI journal (2011:87:Suppl.1) reviews the literature on the feasibility of RM and effectiveness. http://sti.bmj.com/content/87/Suppl_1/A7.5.abstract?sid=0dfd7f4e-457a-4935-ae85-9f1a939b9881
The IRMA report also draws attention the need for further research on attitudes to anal sex in specifically African cultural settings, as well as to the acceptability of RM as a prevention tool, and the integration of anal sex and RM into health education programs. STI journal has featured a number of studies seeking to remedy the paucity of data in this area, and determine risk factors for HIV transmission among MSM, and for their interaction with other populations. These include studies conducted in regions that figure prominently in the IRMA report.
O. Busari, STI 2011:87:Suppl. 1 (Lagos: women and MSM sex workers (SW));
M. Merrigan, STI 2011:87:1 (Lagos, Kano, Cross River States: HIV and Syphilis among MSM);
On the region of southern Africa:
C. Beyrer, STI 2010:86:4 (Malawi, Namibia, Botswana: MSM and bisexual concurrency);
T.G.M. Sandfort, STI 2008:84:6 (South African: racial distribution of HIV amongst MSM).