Abstract: | The increased incidence of HIV/AIDS disease in women aged 15 – 49 years has identified the urgent need for a female-controlled, efficacious and safe vaginal topical microbicide. To meet this challenge, new topical microbicide candidates consisting of molecules or formulations that modify the genital environment (BufferGel?, engineered Lactobacillus, over-the-counter lubricants), surfactants (C31D/Savvy?, sodium dodecyl sulfate, sodium lauryl sulfate), polyanionic polymers (PRO 2000, β-cyclodextrin, Carraguard?, CAP, D2S, SPL-7013), proteins (cyanovirin-N, monoclonal antibodies, thromspondin-1 peptides, Pokeweed antiviral protein and others), reverse transcription inhibitors (PMPA [Tenofovir?]), UC-781, SJ-3366, DABO and thiourea) and other molecules (NCp7-specific virucides, chemokine receptor agonists/antagonists, WHI-05 and WHI-07) are currently being investigated for activity, safety and efficacy. This review will assess the development of these molecules in the context of cervicovaginal defences and the clinical failure of nonoxynol-9. |