Who is IRMA?
Founded in 2005, the International Rectal Microbicide Advocates (IRMA) is a Chicago-based global network of over 1,200 advocates, policymakers and leading scientists from six continents working together to advance a robust rectal microbicide research and development agenda. IRMA’s goal is to support the creation of safe, effective, acceptable and accessible rectal microbicides for the women, men, and transgender individuals around the world who engage in anal intercourse.
IRMA partners with other advocacy organizations around the world to help advance rectal microbicide research, and is funded through grants and individual donations.
AIDS Foundation of Chicago is the IRMA Secretariat.
What is a rectal microbicide?
Currently in development, a rectal microbicide is an agent that could be formulated as a lubricant, gel, douche, or an enema and used rectally to reduce a person’s risk of HIV infection. Rectal microbicides could offer both primary protection in the absence of condoms and back-up protection if a condom breaks or slips off during anal intercourse. Vaginal microbicides are also being studied.
For those unable or unwilling to use condoms, rectal microbicides could be a safe and effective alternative way of reducing risk, especially if they enhanced sexual pleasure and were unobtrusive enough to motivate consistent use.
Such alternatives are essential if we are to address the full spectrum of prevalent sexual practices and the basic human need for accessible, user-controlled HIV and STI (sexually transmitted infection) prevention tools.
Why do we need rectal microbicides?
An act of unprotected anal intercourse is 10 to 20 times more likely to result in HIV infection compared to unprotected vaginal intercourse. Anal intercourse is a common human behavior – among men, women, and transgender individuals – and is a significant driver in the global HIV epidemic. Approximately 5 –10% of the world’s general population engages in anal intercourse.
Among women with multiple risk behaviors for HIV acquisition, an estimated 30 –50% engage in anal intercourse.
Gay men and other men who have sex with men are 19 times more likely to be infected with HIV compared to the world’s general population – in both developed and developing countries. Most of these infections are due to unprotected anal intercourse.
While condoms are an effective barrier to HIV transmission during anal intercourse, many people do not use them for reasons including pleasure, intimacy, relationship dynamics, stigma, and a lack of availability.
Who is doing rectal microbicide research?
The bulk of global rectal microbicide research is led by the Microbicide Trials Network (MTN). The MTN recently conducted the world’s first-ever Phase II safety and acceptability study of a rectal microbicide. The study, completed in 2015, is called MTN 017 and released data at the CROI 2016 conference. Johns Hopkins University is currently developing a rectal douche/enema that could provide protection against HIV through its DREAM project (Development of a Rectal Enema as a Microbicide).