HIV-prevention researchers are excited about a promising experimental prevention strategy known as "oral pre-exposure prophylaxis," or "oral prep," in which HIV-negative individuals who are at high-risk for contracting the virus through sex take a daily dose of antiretroviral drugs, the New York Times reports. Scientists hope that taking one or two antiretroviral drugs daily will prevent people from becoming infected.

Mitchell Warren, executive director of the HIV prevention advocacy group AVAC, said that "we are going to see a cascade of results" from oral prep studies within the next several months. The Times reports that if the results show that fewer people develop HIV after taking the drugs than those taking placebos, regulatory agencies might approve the drugs for prevention. Because antiretrovirals already have been deemed safe and effective for treatment, researchers believe authorities might approve them more quickly than a vaginal gel, another experimental HIV prevention technique.

Vaginal Gel, Ring Also Pursued

Within the last year, promising results from clinical trials of a vaginal gel containing a microbicide that can kill HIV before it infects women was applauded by HIV researchers, the Times reports. The gel can be used by women without their partners' knowledge, "which is crucial because so many men around the world absolutely refuse -- sometimes violently -- to wear condoms when having sex with their wives or girlfriends," according to the Times.

The gel was found to be 40% effective against HIV transmission in a South African clinical trial, according to results released in July. The Times reports that findings from other clinical trials are expected to be released in 2011 and 2012. Researchers hope that one or two products will be ready for the market by 2013, if the other trials are successful.

Researchers also are studying a vaginal ring containing the antiretroviral drug dapivirine, which is not approved in pill form because it does not absorb well in the body. However, the drug can build up in vaginal tissue and is concentrated enough to be effective for one month in ring form. The ring is being tested for possible market entry around 2015.

Experts noted that just as women like having options for birth control, "[p]resumably, they will also want choices in AIDS prevention," the Times reports. Salim Abdool Karim, a professor of epidemiology at South Africa's University of KwaZulu-Natal and a leader of the microbicide trial released in July, said that although regulatory agencies might approve oral prep first, other HIV-prevention methods should be pursued. "The simple truth is: one size does not fit all," he said (McNeil, New York Times, 11/9).

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