Institute Activities and Advances
Research on STDs/STIs 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 Intramural Population Health Research (DIPHR) 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 STDs/STIs, including HIV.
Through the Maternal and Pediatric Infectious Disease Branch (MPIDB), the NICHD cofunds the Microbicide Trials Network (MTN) to study the use of microbicides to prevent HIV and other STD/STI transmission. The Branch also co-funded research that led to the first child being “functionally cured” of HIV. The infant was treated within days of birth with antiretroviral drugs and no longer has detectable levels of the virus off treatment. 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.
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 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 Medicine Trials Network for HIV/AIDS Interventions continues to evaluate the safety of microbicides in adolescents.
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]