Microbicides 2001: The Search for HIV Protection

A microbiologic agent able to prevent 70% of HIV transmissions could have a have a significant impact on the course of the HIV pandemic. Although the rationale for the development of topical microbicides is epidemiologically compelling and scientifically plausible, research has been slow to get off the ground, and the product that has undergone the most detailed scrutiny, N-9, has thus far not been shown to be beneficial in preventing HIV transmission. Until recently, resources for microbicide research have been limited. However, the NIH, CDC, and USAID have developed programs to expedite clinical trials of microbicides and several candidates will soon be entering clinical trials.

With more than 16,000 new HIV infections occurring every day -- and 90% due to sexual contact -- the need for prophylaxis against HIV transmission is acute. Despite major advances in the development and testing of anti-HIV vaccines, a fully effective vaccine will not be available for many years. Meanwhile, only abstinence and the use of barrier protection, particularly male condoms, consistently prevent HIV transmission, and both have serious limitations. Abstinence is not a reasonable approach for most people, and although male condoms can be 99% effective if used regularly and correctly,¹ consistent use is difficult to achieve in most populations, given concerns regarding its impact on sensation and its contraceptive effectiveness, and re…

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Kenneth H. Mayer, M.D.

Microbicides 2001: The Search for HIV Protection

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