Purpose of review: Recent studies suggest that the vaginal delivery of antiretroviral (ARV) agents — such as tenofovir, dapivirine and UC781 — may be a promising way to reduce the high rates of HIV infection among women in developing countries. This review examines these developments.
Recent findings: The Microbicide Trials Network 003 study, a large phase IIb trial, was unable to show that daily dosing with 1% tenofovir vaginal gel was effective for HIV prevention. Nevertheless, preclinical and early-phase clinical trials suggest that ARV drugs — formulated in vaginal gels, rings, films, tablets and diaphragms — could be effective for HIV chemoprophylaxis.
Summary: Investigations of topical chemoprophylaxis methods have seen mixed results in the past 12–18 months. Product adherence may prove to be one of the field's greatest challenges. Phase II and III trials continue to explore different dosing strategies for topical products that contain one or more ARV agents.