This is a comprehensive, technically detailed, review of the scientific advances in vaccine design over the past two decades. With more than 20 vaccines in pre-clinical testing and clinical trials, there is now hope that antibody-based immunity and cellular immunity are achievable goals.

Recent data, including investigation of people who have been exposed to HIV but remain uninfected, are helping to point the way forward. The authors warn, however, that the current crop of clinical trials are unlikely to reveal an effective vaccine, and that several large-scale phase III trials of different vaccine combinations will need to take place, which will require an unprecedented level of international cooperation. Additionally, the extent to which such vaccines can protect or control HIV infection and disease progression remains to be seen.