1. Jim Pickett, IRMA/AFC GMHC – January 23, 2013 The Bottom Line on Rectal Microbicide Research

2. Today Who is IRMA and what does she do? What are rectal microbicides and why do we need them? Brief research update Video: “The Rectal Revolution is Here” Q&A

3. 4 people, 4 agencies, 2 countries 3 IRMA, b.2005

4. 1200+ advocates, scientists, funders, policymakers from 6 continents 4 AIDS Foundation of Chicago is the IRMA secretariat

5. Mission: support development of safe, effective, acceptable, and accessible rectal microbicides for all that need them 5 AIDS Foundation of Chicago is the IRMA secretariat

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7. o Increase and diversify funding o Increase research activities o Lubricant safety o Lubricant access o Increase knowledge o Heterosexual anal sex o Anal sex behaviours and practices in general, anal health Advocacy priorities

8. Activities

9. 9 Highly active moderated listserv Website Blog, Facebook, Twitter, YouTube Global teleconferences Materials and Presentations Focused projects in Africa, S. America

10. Condoms work. So why do we need new strategies to halt the sexual transmission of HIV? 10

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12. What is a microbicide ? A product applied topically in the vagina or the rectum that can offer protection against HIV and, ideally, other STI pathogens Ideally would have a contraceptive version, and another to allow for pregnancy – ARV/non-ARV Formulated as a gel/lubricant, film, or vaginal ring A rectal microbicide (RM) might be delivered via gel/lubricant, douche/enema or … Microbicides are still in development they are not available yet!

13. McGowan I, Biologicals, 2006 Slide courtesy Dr. Ian McGowan How a microbicide works

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15. Anal intercourse is a human behavior.

16. An act of unprotected anal intercourse is 10 to 20 times more likely to result in HIV transmission than an act of unprotected vaginal intercourse.

17. 17 The science

18. Rectal microbicide research RMP 01 – UC-781 MTN 006 – tenofovir MTN 007 – modified tenofovir Project Gel underway MTN 017 36 U.S. 18 U.S. 65 U.S. 120/42 U.S., Puerto Rico 186 Peru, RSA, Thailand, U.S., PR (gay, MSM, TG) 18

19. MTN-017 8 weeks Gel Daily Gel With Sex Oral Truvada Gel With Sex Gel Daily Oral Truvada Oral Truvada Gel With Sex Gel Daily Slide courtesy Dr. Ian McGowan

20. CHARM Program Combination HIV Antiretroviral Rectal Microbicide Program Development of rectal specific ARV microbicides Humanized mouse model Phase 1 studies – Tenofovir – Maraviroc – Tenofovir & Maraviroc IPCP: U19 AI082637 Slide courtesy Dr. Ian McGowan

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22. Thanks to our supporters 22

23. Thank YOU 23

24. 24 Showtime tinyurl.com/RectalRevEnglish tinyurl.com/RectalRevSpanish tinyurl.com/RectalRevThai

25. 25 @rectalmicro rectalmicrobicides.org irma-rectalmicrobicides.blogspot.com facebook.com/InternationalRectalMicrobicideAdvocates For a good time… jpickett@aidschicago.org