To promote research on biological/biomedical options including vaccines, microbicides, treatment for prevention and other strategies for preventing HIV infection, the Indian Council of Medical Research (ICMR) has issued a draft guidance document on 'Research for biological (biomedical) prevention of HIV infection'.
The draft document is meant to provide guidance for researchers in the field and also to position this document as an advocacy tool for greater support for biological/biomedical prevention options. The guidance document addresses the current status of research and research needs with reference to the different facets of prevention research including preclinical development, clinical trials and access; the gaps that need to be addressed and infrastructure needs.
According to senior officials in the ICMR, the guidance document has been prepared after extensive consultation with experts in this field. The ICMR has invited comments and suggestions from experts and other on this draft guidelines for finalization of the document till April 30, 2014.
Officials said that recent breakthroughs in HIV biomedical prevention research open new doors to reducing the scope of the epidemic. This progress also poses new questions and brings new challenges as we continue to move HIV biomedical prevention research forward. Understanding the needs and gaps in these efforts will help in providing appropriate direction and further impetus for research on biomedical prevention tools.
Currently, the country has an estimated more than 20 lakh people living with HIV/AIDS in 2011. The Indian epidemic is geographically diverse and is a mix of generalized and concentrated epidemics in different districts. While the epidemic is primarily expanded through heterosexual transmission with transactional sex being the main driver of transmission, intravenous drug use and 'men having sex with men' are also important drivers; and the female partners of both these core populations form an important key/vulnerable group where the epidemics intersect.
Overall high disease burden due to HIV, continuing high prevalence of HIV infection in certain populations and geographic areas and the limitations associated with interventions for behaviour change underline the need for a basket of biomedical options for prevention of HIV infection in India.
Along with necessary individual, social, structural, societal and developmental changes, a broad range of biomedical HIV prevention and treatment options is required to meet the diverse needs of individuals and populations. Comprehensive HIV prevention requires a combination of programmatic and policy actions that promote safer behaviours; reduce vulnerability to transmission; encourage use of key prevention technologies; promote social norms that favour risk reduction; and address drivers of the epidemic.