via AIDSTAR-One, by Jim Pickett (IRMA chair)

[This article was written for AIDSTAR-One’s “Spotlight on Prevention” series.]

Until recently, microbicide research has focused on vaginal microbicides. Recent initiatives and ongoing studies highlight the need for safe and effective rectal microbicides as part of an essential HIV prevention toolkit.

Around the turn of the millennium, the microbicide field was almost solely focused on the research and development of vaginal microbicides, and community engagement and advocacy aligned with this priority. If scientists and advocates considered rectal microbicides (RMs) at all, it was strictly in the context of the need to test vaginal products for rectal safety, with the understanding that when a vaginal microbicide made it to market, it would likely be used in the rectum as well, or would migrate there during vaginal intercourse.

The realities of the HIV epidemic, though, point to anal intercourse (AI) as a practice that both men and women engage in, and as a significant factor in the spread of HIV and other sexually transmitted infections (STIs). The work of a growing number of scientists and advocates has brought us to the early days of a new consciousness some are calling “the rectal revolution,” where researchers are investigating the role of RMs and related products as essential elements of HIV prevention. This summary describes where we are in the rectal revolution, and where we need to go.

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