Researchers are developing several lines of attack against HIV, all of which show promise in reducing infection rates.
The field of pre-sex HIV prevention is "red-hot cool right now", says Sharon L. Hillier, a gynaecology professor at the University of Pittsburgh's medical school and principal investigator of the Microbicide Trials Network.
Earlier this year a clinical trial showed for the first time that a microbicide gel can help prevention of HIV. With other trials planned for 2011–2012 researchers hope the gel will be on the market by 2013.
But other options may also soon become available. Results from trials on the use of oral pre-exposure prophylaxis, or 'oral prep' for short, are expected to start over the next few months, according to Mitchell Warren, executive director of AVAC, an advocacy group for AIDS prevention. Oral prep involves giving a daily dose of antiretrovirals to people in the high risk groups, such as sex workers.
If the method works, approving the use of such pills would be much faster than approving a new gel, because they have already proved safe and effective in the treatment of HIV/AIDS.
A trial is planned for next year for another method: a vaginal ring containing the antiretroviral drug dapivirine. Dapivirine does not work as a pill as the body fails to absorb the drug, but if used in a ring loaded with the drug it could work in the vaginal tissue.
"The simple truth is: one size does not fit all," says Salim Abdool Karim, epidemiologist at the University of KwaZulu-Natal in South Africa and a leader of the successful microbicide trial. Just as people like to have a choice of birth control methods, they will also like to have a choice of AIDS prevention methods, experts say.