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The Mary Magdalene Project
RBMOnline - Vol 12. No 3. 2006 388 Reproductive BioMedicine Online; www.rbmonline.com/Article/2177 on web 12 January 2006
International scene The Mary Magdalene Project Keywords: HIV infection, lemon juice, prevention
This brief communication presents a case for funding new approaches to HIV prevention in developing countries. A recently published paper from Nigeria shows that a high proportion of female commercial sex workers are currently using vaginal douches of lime or lemon juice before or after sex in the belief that this protects them from both pregnancy, and some sexually transmitted diseases; they do not know their HIV status (Imade et al., 2005). Can we help female commercial sex workers to find simple, safe, cheap and readily available ways of protecting themselves against HIV infection? Their profession makes them particularly susceptible to infection. It is often impossible for them to insist that their male customers use condoms, and some men make the situation worse by bribing the women to have unprotected sex. Many female commercial sex workers in developing countries are living in extreme poverty. Sex may be the only thing they have to sell, and yet they are in the front line of our fight to contain the global spread of HIV infection. How can we help them? Recent research has indicated two exciting possibilities: intravaginal lime or lemon juice has been used by European women for centuries as a very effective contraceptive. Doctors in Jos, Nigeria, have recently made a major breakthrough. They have discovered that over 80% of female commercial sex workers in that city are routinely using intravaginal douches of lime or lemon juice immediately before or after intercourse in the belief that this is protecting them from pregnancy, and sexually transmitted diseases in general. They do not know their HIV status. We urgently need to discover whether citrus juice is protecting these women from HIV infection or whether it is harmful. They provide us with an amazing opportunity, since there can be no ethical objection to studying existing citrus juice users. The study could begin immediately if funding became available. Another promising line of research is to see if the oral contraceptive pill, taken intravaginally, could protect women from HIV infection. We already know that the pill taken vaginally is an extremely effective contraceptive. The oestrogen in the pill should also thicken and keratinize the vaginal epithelium, and monkey studies have shown that vaginal oestrogen gives significant protection against vaginally administered simian immunodeficiency virus. Once again, we urgently need to discover whether this simple approach would protect female commercial sex workers from HIV infection. Studies could begin immediately if funding was available.
388
Funding opportunities for work on commercial sex workers recently received a major setback. The Washington Post of 6 March 2005 reported that the Bush administration had announced a new policy requiring all US HIV/AIDS groups seeking federal funding for work overseas to make a written pledge to oppose commercial sex work,
or risk losing funding. The editorial rightly criticises the Bush administration for allowing its AIDS efforts to be governed by utopian delusions, and concludes by saying ‘it would be nice if the prostitutes the world over could be helped toward a different way of life. But the world’s oldest profession is not going to disappear and millions of lives depend on getting AIDS prevention services to its practitioners’. Amen to that. Courageously, the government of Brazil immediately put its money where its mouth is and refused $40 million of US funding to fight AIDS, saying that Bush’s ideological conditions were too severe. Bravo Brazil! In the light of all these developments, we have decided to launch a Mary Magdalene Project, initially to fund the two HIV prevention trials among the female commercial sex workers of Jos, Nigeria, as outlined above. The project is named after Mary Magdalene who was thought to have been a prostitute and subsequently became one of Christ’s disciples. Her Saint’s Day is observed on 22 July; she has colleges named after her in both Cambridge and Oxford. The Mary Magdalene Project was launched at the Annual Conference of the Royal Australasian College of Physicians in Wellington, New Zealand, on Tuesday 10 May 2005, when the author delivered the Priscilla Kincaid-Smith Oration on ‘Preventing HIV infection in women in the developing world’. The project has already raised US$30,000 and we need to reach US$200,000 for the project to begin. Contributions to the Mary Magdalene Project may be sent to: The Australian AIDS Fund Incorporated, PO BOX 1347, Frankston Vic 3199, Australia. Roger V Short The Dean’s Ganglion, Faculty of Medicine, University of Melbourne, Victoria, Australia.
Reference Imade GE, Sagay AS, Omwuliri VA et al. 2005 Use of lemon or lime juice douches in women in Jos, Nigeria. Sexual Health 2, 237–239. www.aids.net.au Received 30 November 2005; refereed and accepted 22 December 2005.
International scene The Mary Magdalene Project Keywords: HIV infection, lemon juice, prevention
This brief communication presents a case for funding new approaches to HIV prevention in developing countries. A recently published paper from Nigeria shows that a high proportion of female commercial sex workers are currently using vaginal douches of lime or lemon juice before or after sex in the belief that this protects them from both pregnancy, and some sexually transmitted diseases; they do not know their HIV status (Imade et al., 2005). Can we help female commercial sex workers to find simple, safe, cheap and readily available ways of protecting themselves against HIV infection? Their profession makes them particularly susceptible to infection. It is often impossible for them to insist that their male customers use condoms, and some men make the situation worse by bribing the women to have unprotected sex. Many female commercial sex workers in developing countries are living in extreme poverty. Sex may be the only thing they have to sell, and yet they are in the front line of our fight to contain the global spread of HIV infection. How can we help them? Recent research has indicated two exciting possibilities: intravaginal lime or lemon juice has been used by European women for centuries as a very effective contraceptive. Doctors in Jos, Nigeria, have recently made a major breakthrough. They have discovered that over 80% of female commercial sex workers in that city are routinely using intravaginal douches of lime or lemon juice immediately before or after intercourse in the belief that this is protecting them from pregnancy, and sexually transmitted diseases in general. They do not know their HIV status. We urgently need to discover whether citrus juice is protecting these women from HIV infection or whether it is harmful. They provide us with an amazing opportunity, since there can be no ethical objection to studying existing citrus juice users. The study could begin immediately if funding became available. Another promising line of research is to see if the oral contraceptive pill, taken intravaginally, could protect women from HIV infection. We already know that the pill taken vaginally is an extremely effective contraceptive. The oestrogen in the pill should also thicken and keratinize the vaginal epithelium, and monkey studies have shown that vaginal oestrogen gives significant protection against vaginally administered simian immunodeficiency virus. Once again, we urgently need to discover whether this simple approach would protect female commercial sex workers from HIV infection. Studies could begin immediately if funding was available.
388
Funding opportunities for work on commercial sex workers recently received a major setback. The Washington Post of 6 March 2005 reported that the Bush administration had announced a new policy requiring all US HIV/AIDS groups seeking federal funding for work overseas to make a written pledge to oppose commercial sex work,
or risk losing funding. The editorial rightly criticises the Bush administration for allowing its AIDS efforts to be governed by utopian delusions, and concludes by saying ‘it would be nice if the prostitutes the world over could be helped toward a different way of life. But the world’s oldest profession is not going to disappear and millions of lives depend on getting AIDS prevention services to its practitioners’. Amen to that. Courageously, the government of Brazil immediately put its money where its mouth is and refused $40 million of US funding to fight AIDS, saying that Bush’s ideological conditions were too severe. Bravo Brazil! In the light of all these developments, we have decided to launch a Mary Magdalene Project, initially to fund the two HIV prevention trials among the female commercial sex workers of Jos, Nigeria, as outlined above. The project is named after Mary Magdalene who was thought to have been a prostitute and subsequently became one of Christ’s disciples. Her Saint’s Day is observed on 22 July; she has colleges named after her in both Cambridge and Oxford. The Mary Magdalene Project was launched at the Annual Conference of the Royal Australasian College of Physicians in Wellington, New Zealand, on Tuesday 10 May 2005, when the author delivered the Priscilla Kincaid-Smith Oration on ‘Preventing HIV infection in women in the developing world’. The project has already raised US$30,000 and we need to reach US$200,000 for the project to begin. Contributions to the Mary Magdalene Project may be sent to: The Australian AIDS Fund Incorporated, PO BOX 1347, Frankston Vic 3199, Australia. Roger V Short The Dean’s Ganglion, Faculty of Medicine, University of Melbourne, Victoria, Australia.
Reference Imade GE, Sagay AS, Omwuliri VA et al. 2005 Use of lemon or lime juice douches in women in Jos, Nigeria. Sexual Health 2, 237–239. www.aids.net.au Received 30 November 2005; refereed and accepted 22 December 2005.