AIDS focus shifts to women and prevention

TORONTO, Aug 15 (Reuters) Researchers, activists and major funders have agreed to a shift in the fight against AIDS to focus on prevention and especially helping women protect themselves.

With big pharmaceutical companies making their HIV drugs available cheaply to developing nations and with generic drugs available, speakers at the 16th International Conference on AIDS agreed the focus needs to move to preventing new infections.

''Prevention of HIV had slipped off the agenda and now is being pushed by unexpected quarters,'' Dr Peter Piot, head of the United Nations AIDS agency UNAIDS, said in an interview.

That includes activists who had previously focused on getting lifesaving drugs to infected people, he said.

''Before, if I had mentioned prevention, I would be accused of being against treatment,'' Piot said.

In opening the conference in Toronto on Sunday, Microsoft founder Bill Gates, who has donated hundreds of millions of dollars to AIDS programs, said he would be seeking good prevention programs that focused on women.

These will include the development of microbicides -- gels or creams that can prevent sexual transmission of the fatal and incurable virus.

Just over half, or 17.3 million, of 34 million adults currently infected with the AIDS virus are women, according to the World Health Organization.

With nearly 39 million people now infected with the virus, more than 4 million new infections a year and 2.8 million deaths, the need for prevention is clear.

But some political and religious leaders are standing in the way of effective programs, several experts said.

''The problem with prevention for many is that you cannot avoid dealing with sex and drugs,'' Piot said.

Barbara Lee, a member of the US House of Representatives, said the administration of President George W Bush may have to be forced into changing its policies that stress abstinence as the best prevention method.

As the world's largest funder of AIDS programs, the United States is a major factor, noted Lee, a California Democrat.

GOING WITH WHAT WORKS ''What we see is a very ideologically driven administration, both domestically and internationally, trying to put their moral values ... on communities and countries,'' Lee told a news conference.

She is sponsoring legislation that would eliminate US requirements that 33 per cent of all cash spent on prevention go to promoting abstinence-only-until-marriage approaches.

''We know that abstinence only before marriage doesn't work,'' said Stephen Lewis, the UN ambassador to Africa for AIDS.

One promising approach is called PreP, for pre-exposure prophylaxis. Some early studies suggest that people at high risk of infection could take one or two of the safest drugs used as part of HIV cocktails to help protect themselves.

''If you are a female sex worker who is working every day obviously you have to take it every day,'' Dr Joep Lange of the University of Amsterdam in the Netherlands, told a news conference.

''If you are the wife of a truck driver in Tamil Nadu (in India), you can take it just before he comes home and you can take it when he doesn't see it being taken.'' One big funder, the Global Fund to Fight AIDS, Tuberculosis and malaria, said it would continue to look at proven programs.

''We are financing some of it already. We'd like to finance more,'' Richard Feachem, the Global Fund's executive director, told a news conference.

Feachem said the fund, which received a 500 million dollars pledge from Gates last week, needed 600 million dollars more for its upcoming round of funding for 2007.

That means governments, experts agreed.

''You cannot replace the state and government when you are dealing with a massive problem like AIDS, and it cannot come only from rich countries,'' Piot said.

''Honestly, China is flooding the world with goods. They have to start investing in social issues.'' REUTERS MS BST1016