Microbicide advances are ahead of vaccines but still years away: prevention approaches are varied.

Recent research has shown that the microbicide field is alive with an array of prevention approaches to stopping HIV transmission during sexual intercourse.

However, most researchers admit that while the pipeline of microbicide research is further along than the vaccine pipeline, it still could be five to 10 years before the ideal candidate is marketed.

Also, about $775 million needs to be invested in testing products already in development before it's likely there will be a successful product by 2010, according to UNAIDS of Geneva and an estimate by the Rockefeller Foundation of New York City.

The first microbicide phase III clinical trial to study HIV infection involved Nonoxynol-9, which was a disappointment to the microbicide field when the product apparently increased risk of HIV infection among study subjects. However, most researchers agree that it wasn't a major surprise, and it hasn't hindered the progress of new approaches to finding an HIV microbicide.

"Essentially, the trial was carried out because the product was already out there as a spermicide," says Robin Shattock, PhD, a reader in cell biology of infection in the department of cellular and molecular medicine, infectious diseases at St. George's Hospital Medical School in London. Shattock was scheduled to speak about microbicides at the recent Microbicides 2004 conference, held March 28-31 in London.

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