Institute Activities and Advances
Research on sexually transmitted infections (STIs) and sexually transmitted diseases (STDs) falls into the portfolios of several NICHD organizational units. Some of their activities are explained below.
The Population Dynamics Branch (PDB) funds studies of sexual behaviors related to disease prevention in a variety of populations and intervention studies to modify risky sexual behaviors. This includes basic and intervention research on the demographic, social, and behavioral aspects of the sexual transmission of HIV and other STDs/STIs. The Branch also promotes a population perspective on the HIV epidemic by examining the causes and consequences of the epidemic in and across populations.
Investigators in the Epidemiology Branch of the Division of Epidemiology, Statistics, and Prevention Research (DESPR) have pursued an active program of research to determine the etiology of bacterial vaginosis (BV). Little is known about how the condition is acquired and maintained. Researchers are not sure why the condition is more than twice as prevalent among African American women. They also do not know why BV is consistently associated with serious adverse health outcomes, including an increased incidence of spontaneous abortion, failure of in vitro fertilization, preterm delivery, postoperative obstetric and gynecologic infections, pelvic inflammatory disease, and acquisition of other STIs, including HIV.
Through the Maternal and Pediatric Infectious Disease Branch (MPIDB), the NICHD supports the Microbicide Trials Network to study the use of microbicides to prevent HIV and other STI transmission. The Institute has also created several intervention programs that strive to understand factors that influence teen decision making regarding sexual behaviors that increase the risk of STDs/STIs. Additionally, the NICHD co-funds the Women's Interagency HIV Study (WIHS), the largest and longest ongoing study of HIV-infected women. WIHS data are providing a great deal of information about STDs/STIs and the nature of risky sexual behaviors in women.
One recent advance includes a trial to assess the safety, adherence, and acceptability of a topical vaginal microbicide and to determine how it affects vaginal microflora among sexually active young women. The product has the potential to eventually be available over the counter. The topical microbicide gel has been shown to inhibit HIV, herpes simplex virus-2, and human papillomavirus in vitro and in animal models. In general, the study findings show no serious adverse events linked to the experimental microbicide; however, side effects included genital irritation or inflammation.1 Collaboration between the MTN and the Adolescent Trials Network continues to evaluate the safety of microbicides in pregnancy.
Other Activities and Advances
- McGowan, I., Gomez, K., Bruder, K., Febo, I., Chen, B., Richardson, B., et al.; the MTN-004 Protocol Team. (2011). Phase 1 randomized trial of the vaginal safety and acceptability of SPL7013 gel (VivaGel) in sexually active young women (MTN-004). AIDS, 25, 1057–1064. Retrieved July 11, 2012, from http://journals.lww.com/aidsonline/Abstract/2011/05150/Phase_1_randomized_trial_of_the_vaginal_safety_and.6.aspx [top]