Lack of power and autonomy is the root cause of women’s vulnerability. But empowerment will take generations!
The spermicide nonoxynol 9 which has been available for many years and was generally regarded as safe, kills HIV in the test tube and provides a physical, "gooey" barrier which sperm and microbes cannot penetrate.
But it has recently been discovered that it causes vaginal lesions which could then be entry points for HIV.
Some argue that in the trials, which were halted, it was used in far too high concentrations and in women (sex workers) who were using it several times in an evening. This does not represent typical use.
Sixty candidate microbicides are in the pipeline; but none will be available to the public very soon.
Research and Development is being done by small biotechnology companies, individual academic researchers, on shoestring budgets.
Development costs tens of millions of dollars which only the big pharmaceutical companies have.
Trials must meet high ethical standards, e.g. all women enrolled must use both condom and microbicide; huge numbers of participants required and will be very costly.
Microbicides are not seen as profitable; principle market being poor women. Advocates argue that the potential market is larger than this.
Some advocates say candidate microbicides should be distributed at low cost to women in need, before further testing. They are generally regarded as safe, we just don’t know how well they work - 80% or 30% efficacy.