HIV and STD Prevention: The Cervical Cap and Microbicides

The search for HIV prevention has led to an exploration of a variety of methods developed to offer protection from sexually transmitted diseases. One of the most feasible options to date is the microbicide for the prevention of STDs - particularly HIV AIDS. While this method of STD prevention has failed in the past, recent developments have improved this device. The cervical cap known as the FemCap, in combination with a microbicide gel, could offer a viable option for HIV AIDS prevention in women.

What is a Microbicide?
A microbicide is a compound or substance that is used for the purpose of preventing infection of bacteria or viruses such as the HIV virus. Topical microbicides such as gels could be applied to condoms or directly to genitals in order to prevent infection of sexually transmitted diseases (STDs).

In the early years of the HIV AIDS pandemic, microbicides such as Nonoxynol-9 and, more recently, Cellulose Sulphate were used in an attempt to prevent STDs. However, these methods failed and even increased the risk of HIV transmission. Nonoxynol-9 in particular failed because although it destroyed the cell wall of the HIV, it also irritated the surface of the cervix, vagina, and rectum. This irritation led to the formation of sores, which served as sites for HIV AIDS and other STD infections.

HIV Infection and The Cervix
One of the major failures of microbicides in the past is attributed to a failure to take basic anatomy and immunology into consideration. In other words, how HIV AIDS infects a woman's body.

The cervix is actually the main site of HIV invasion, and is thus the area that requires the greatest protection. The cervical canal is lined with a single layer of vascular epithelium, which is extremely fragile. The cervix also has a high concentration of chemokine receptors (CCR-5 and CXCR-4) and many lymphocytes are present in this region. These receptors - which are almost absent from the mucus membranes of the vagina - must be present in order for HIV infection to occur.

According to some research, any irritation caused by microbicides will mobilize immune cells to the cervix, making them a target for HIV invasion and replication. This is particularly dangerous for women with cervical ectopy, a condition in which a single layer of endo-cervical cells extends beyond the border of the cervical os (cervical opening).

The FemCap and Microbicides
The FemCap in combination with a new microbicide known as Acidform (Amphora) has emerged as one potential method of STD/HIV prevention in light of recent research.

Amphora is classified as a vaginal defense enhancer, and some believe it to be the most promising microbicide presently available. This is because it claims to fulfill two basic criteria:

  • does not irritate the cervix
  • does not stimulate the immune system

Amphora aims to preserve vaginal acidity even in the presence of semen. It also claims to protect and insulate the mucus membrane from HIV invasion, and kill STD and HIV organisms on contact.

Applying Amphora requires the use of a cervical cap known as the FemCap, which has long been approved in the United States and Europe as one of many viable birth control methods.

How FemCap Works
Previous use of microbicides involved either an applicator or a diaphragm. Supporters of the FemCap method point out that both of these methods of contraception cause irritation of the cervix and stimulate the immune system, putting individuals at greater risk of HIV infection. In the case of the diaphragm, the cervix is actually steeped in a pool of microbicides, increasing the risk of irritation.

The FemCap covers and protects the cervix from both the effects of microbicides as well as STD and HIV contact by acting as a barrier. The design of the FemCap allows for the storage and delivery of microbicides to the vaginal side, allowing the cervix to remain protected while killing STD organisms as soon as they come into contact with the vagina. The microbicide is naturally expelled through the vagina.

This method offers a potentially new option for the prevention of STD and HIV AIDS. Speak to your health care provider for more information about the FemCap and microbicides for STD prevention.

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