Marseille 2007
| Abstract #359 - Microbicideswhy so slow? Lessons from history. | ||||
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Session: 6.55: Posters A (Poster) on Monday in Chaired by Authors: Presenting Author: Dr Ilana Lowy - INDERM, France, Metropolitan |
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| Additional Authors: | ||||
| Aim: To investigate historical roots for difficulties to develop microbicides. | ||||
| Method / Issue: The first investigation on microbicides started in the mid-1980s, but for ten years research on topical prevention of HIV infection did not attract much attention or funding, Our hypothesis is that the past but also some of the present time difficulties to develop research on microbicides are related to the complex history of women-controlled contraceptive substances: spermicides and local disinfectants. | ||||
| Results / Comments: We are following three leads: *The liminal status of spermicides. For a long time, studies of human fertility and contraception were for a long time outside the scope of "respectable" science. The marginal status of these investigations was attenuated by legalization of contraception, but it did not disappear altogether.. *The medicalisation of contraception. Contraceptives were associated with quack science and back alley abortionists. In order to make them more respectable, activists who fought for women's right to control their fertility promoted doctor-controlled contraception. This trend to delegate the responsibility for contraception to the medical profession was accelerated with the development of the contraceptive pill and IUD. *The rise of randomized clinical trials and evidence based medicine. The growing importance of RCT as the sole method of displaying efficacy of therapeutic or preventive substance and the sole valid criterion for obtaining a marketing permit strongly favored devices that can be easily tested in such trials, and those which perform best under controlled conditions | ||||
| Discussion: We identified the following research questions: -The historical roots of marginality of spermicides in the light of past medical debates on this subjet. ii.The role of debates on the efficacy contraceptive pill in devalorising spermicides. iii.The history of construction of evidence in testing spermicides and local disinfectants, especially after the advent of hormonal contraception. iv.Patterns of evaluation of efficacity of protective devices: absolute versus real-life efficacity | ||||
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