A microbicide is a substance designed to reduce the spread of HIV and other sexually-transmitted diseases (STDs) when applied to the vagina or rectum. A microbicide could come in many forms, including gels, creams, suppositories, films, lubricants, sponges, or vaginal rings.

No. Scientists are currently testing many substances to see whether they help protect against HIV and/or other STDs, but no safe and effective microbicide is currently available to the public. However, scientists are seriously pursuing dozens of products, including 12 that have been proven safe enough in lab studies that they are now being tested in people. It is unlikely that an effective microbicide would become available to the public before 2010.

A microbicide could work in three different ways:

1. Killing or neutralizing germs such as bacteria and viruses.
2. Blocking infection by creating a barrier between the germ and the cells of the vagina or rectum.
3. Preventing the germ from mulitplying after it has entered the body.

No. When used consistently and correctly, male or female condoms are likely to provide better protection against HIV and other STDs than microbicides, so they will still be the best choice. But for people who cannot or will not use condoms, and particularly for women whose partners refuse condoms, using microbicides could save lives and have a major impact in reducing the spread of HIV.

Many of the microbicides currently being tested work against HIV and at least one other STD. Eventually, a product that combines different microbicides could offer protection from a wide range of STDs, including HIV.

Not all of the microbicides being investigated prevent pregnancy.  It is important to have both non-contraceptive microbicides as well as “dual-action” microbicides that prevent pregnancy and STDs. Non-contraceptive microbicides would offer women the option of potentially getting pregnant while still protecting themselves from infection – an alternative that is not available with condom use.

Any new product must go through rigorous safety testing before becoming available to consumers. Women’s health activists and researchers are working closely together to ensure that the clinical testing of microbicides is done in a way that is both careful and comprehensive.

Scientists believe that a woman’s male partner would also be protected from infection if she used a vaginal microbicide. Microbicides may work if they are used rectally, but the safety and effectiveness of microbicides for rectal use must be established separately. Rectal safety studies of some potential microbicides are beginning.

Microbicides could help protect women living with HIV (HIV+) from re-infection with other HIV strains and from other STDs that can be more dangerous when the immune system is already challenged.

Microbicides are likely to protect both partners, giving HIV+ women another option for helping protect their partners who may not use condoms. Some microbicides may also prevent pregnancy and others may not. Microbicides that do not prevent pregnancy but do prevent HIV transmission would give HIV+ women who want to have children the ability to do so with less risk to an HIV-negative partner. Microbicides that also prevent pregnancy would give women another way to avoid an unwanted pregnancy.

Non-profit and academic institutions and small biotech companies conduct almost all microbicide research. Funding comes from federal research grants and private foundations. Only a few smaller pharmaceutical companies have taken an interest in this field.

HIV vaccine research has not been successful so far. Microbicides will likely be available and accessible much sooner than an HIV vaccine. Even if a safe and effective vaccine is discovered, vaccines and microbicides will have different, complementary roles to play in the prevention of HIV.

Advocates are working with researchers and policy makers to ensure that any approved microbicide will be as affordable and accessible as possible.

N-9 products are sold over the counter as spermicides that can prevent pregnancy, but cannot prevent the transmission of HIV or other infections. In fact, when used more than once a day, N-9 contraceptive products may actually increase HIV risk by irritating vaginal membranes and causing abrasions that make it easier for the virus to enter the blood stream. Other studies show that N-9 is even more irritating to rectal tissue than to vaginal tissue.

In 2001, World Health Organization (WHO) experts came to the following conclusions:

• N-9 is not effective at preventing the transmission of HIV or other STDs. It should NOT be used for disease prevention.
• N-9 contraceptive products (used alone or with a diaphragm or cervical cap) offer an important option for women who chose not to use hormonal birth control methods. But N-9 may also increase a woman's chances of getting infected, if exposed to HIV. Women at risk for HIV, especially those having sex more than once a day, should NOT use N-9 for birth control.
• Women who are not at risk for HIV can continue to use N-9 for birth control purposes safely.
• Condoms with N-9 provide no more protection against pregnancy or infection than plain lubricated condoms. Since N-9 condoms may cause irritation, they should not be promoted for any purpose.
• Products with N-9 should NEVER be used for anal sex.

Until microbicides are available, the best way to protect yourself and your partner from STDs, including HIV, is by using a male or female condom. It is also important to avoid the use of nonoxynol-9 (N-9) products if you think there is any chance you may be exposed to HIV. Getting tested for STDs regularly and getting treatment promptly if you have an STD will also help reduce your risk of HIV infection if you are exposed to HIV.