Microbicides: where are we now and what next?

摘要

Women in sub-Saharan Africa are disproportionately affected by HIV for biological and sociocultural reasons. Many are unable to negotiate condoms, or unwilling to do so as they wish to conceive, or both. For two decades scientists have been searching for a method to prevent HIV that women can initiate and be responsible for. The female condom addresses some of these needs, but prevents conception. Delivering drugs locally to the genital tract in the form of a vaginal microbicide has long been envisaged as a way to fill the gap, and in 2010 there is finally proof of concept for this method, with the report of a significant reduction in HIV infections in women using tenofovir 1% vaginal gel compared with those using placebo [1].