Young women account for nearly 60 per cent of all HIV positive adults in sub-Saharan Africa. Many are unable to negotiate the use of condom with their partners and some rely on trading sex for food or shelter.

Helen Pilcher reviews the reasons why developing nations need microbicides — gels and creams that are inserted directly into the vagina or rectum — may offer discreet protection from HIV infection. As yet, there are no microbicides on the market but six large clinical trials have begun or will begin later this year.

Microbicides would offer protection to women who don't have the option of using condoms. Some microbicides could also be non-spermicidal, providing protection from sexually transmitted diseases yet allowing couples to conceive. And while it is likely that microbicides would be only partially effective, research has shown that a 60 per cent effective product could prevent 2.5 million HIV infections worldwide over three years.

Reference: Nature 430, 138 (2004)

Link to full article in Nature