Why Microbicides are Needed

The introduction of a microbicide could have a major public health impact. Early modeling of the impact of microbicide use among female sex workers has suggested that a 30-50% effective microbicide could reduce the daily HIV risk among sex workers by 17%; a 50-80% effective microbicide could reduce daily HIV risk by 28%.¹ Other research suggests that a microbicide with 60% efficacy, used by 20% of sexually active individuals in 73 low-income countries, could prevent 2.5 million HIV infections over three years.²

What's special about microbicides?

• They would provide a woman-initiated method of HIV prevention.
• Some may prevent pregnancy.
• Eventually, many are likely to be available over-the-counter.
• They are being designed to be inexpensive.
• Some may boost the vagina's natural defense mechanisms.
• Microbicides formulated as gels would provide protective lubrication that could add to sexual pleasure.

Why not use a condom?

Condoms are still the preferred prevention method, and if used consistently and correctly, are likely to protect better against HIV and other STIs. However, condom use is sporadic for many people. In sub-Saharan Africa - the area hardest hit by the HIV epidemic - less than 7% of women report having used a condom during their last sexual contact with a primary partner; among women with casual partners, less than 50% report having used a condom during their last sexual contact with a casual partner.³ Cultural norms, economic disparities, and gender inequality can make negotiating condom use difficult for many women. Recent research conducted in Zambia demonstrates that negotiating condom use can be difficult even in the face of infidelity or known HIV risk: only 11% of Zambian women thought they had the right to request condom use with their husband, even if he was HIV-positive or had other partners.⁴ Microbicides would be critical for women who cannot control condom use in their relationships.

More information about microbicides is available from the Alliance's Fact Sheets.