What are microbicides, and why are they needed? Could they be used by men and women? And when will they be available? The resources in this section provide basic information about microbicides in the context of biomedical HIV prevention, including information about topical and oral use of antiretroviral (ARV) drugs for HIV prevention.
Proof of concept has been demonstrated for both a vaginal microbicide containing an ARV drug and for oral use of ARVs as pre-exposure prophylaxis (PrEP). The U.S. Food and Drug Administration and the drug regulatory agencies in South Africa and Kenya have approved a combination of the ARV drugs emtricitabine and tenofovir disoproxil fumarate (TDF/FTC, or Truvada) for daily use as oral PrEP to reduce the risk of HIV infection in uninfected men and women who are at high risk of HIV infection through sexual intercourse. Studies have also shown that early treatment of HIV-infected individuals with oral ARV drugs can dramatically reduce the risk of transmission to an uninfected partner as well as lowering the risk of serious illness and death. In September 2015, the World Health Organization recommended that anyone living with HIV begin antiretroviral therapy as soon after diagnosis as possible and that PrEP be offered as an option to all people living in contexts or communities with an HIV incidence of 3 percent.
Research is under way to identify multipurpose prevention technologies that could prevent a combination of pregnancy and HIV or other sexually transmitted infections. For example, researchers are assessing microbicide gels, gel capsules, or films that could be used with barrier methods of contraception or could be delivered via vaginal rings or diaphragms to prevent both pregnancy and HIV. This section also includes the most up-to-date information on the development of these technologies.