In North America and Europe, HIV is most prevalent in the gay population. But in sub-Saharan Africa, where the virus has taken the greatest toll, the face of the epidemic is a young African woman, said Elizabeth Bukusi, deputy director of research and training at the Kenya Medical Research Centre.
"We need an option that women have the choice about using," Bukusi said. "If she can't protect herself because her partner will not put [a condom] on, we need her to have something she can use to protect herself."
At Crossroads, a poor township with one of the highest rates of HIV in South Africa, residents are recruited for various HIV prevention studies. In return, participants are offered health care and the community receives educational and recreational programs.
For two years, Ntanda Kiwana has attended a clinic for monthly checks as part of a trial to see whether a vaginal ring with a long-acting microbicide embedded in it can prevent women from becoming infected.
"I don’t even feel it," she said.
Prof. Sharon Hillier of the University of Pittsburgh is principal investigator for the Microbicide Trials Network, directing research projects in seven countries.
"I think microbicides are just the kind of empowering tool that give women the chance to control their own health," Hillier said.
There are several microbicide designs that work to provide a physical barrier to keep out HIV and other sexually transmitted viruses from attaching to the vaginal walls or boost natural vaginal defences, such as by manipulating acidity levels.
So far, one study has shown a microbicide gel is partially effective against HIV. Researchers say two large studies reporting results in 2015 will likely confirm and possibly surpass that finding.
Two trials with microbicidal rings will release results shortly after. If the trials are successful, the products could be available to use commercially in a few years.
The HIV Research for Prevention Conference in Cape Town ends tomorrow.