Here’s a reality check, courtesy of global advocacy group AVAC: We know that HIV prevention methods such as pre-exposure prophylaxis (PrEP), vaginal gels and male circumcision can work. But scientific trials “have given rise to important questions, not only about women’s willingness to use the test product, but about the research process itself.” In its latest yearly report, Research & Reality, AVAC focuses on prevention for women—who, after all, make up half the global HIV population.

A few AVAC suggestions: Don’t abandon vaginal gels; do invest in treatment adherence programs for people living with HIV; try to better understand why women enroll in prevention trials and then do or do not take the study product; and select trial participants likely to adhere to the regimen. As Helen Rees, an AVAC board of directors member in South Africa notes, “We urgently need to identify a range of prevention options that can work for women—and then we need to know which options will work best for which women.”