Vaginal and rectal microbicides are products designed to enable HIV-negative men and women to protect themselves from HIV. Antiretroviral microbicides could be delivered via gels, films, foams, inserts or suppositories. A fast-dissolving insert containing elvitegravir and tenofovir alafenamide appears promising for either rectal or vaginal use in early studies. However, no vaginal or rectal microbicides are currently approved for HIV prevention.

For the past decade, researchers have been studying the effectiveness of long-acting vaginal rings containing antiretrovirals. The ASPIRE study and the Ring Study both showed that a ring containing dapivirine reduced the risk of acquiring HIV by approximately 30% in young women. The ring is approved in other countries, but in 2022 it was withdrawn from Food and Drug Administration consideration.

Researchers are also studying implants inserted under the skin that could offer protection for a year or longer. Implants containing the antiretrovirals islatravir and cabotegravir are under study. Different types of islatravir implants have been shown to protect monkeys from vaginal and rectal exposures using an HIV-like virus. No implants are currently approved for HIV prevention.

Last Reviewed: April 2, 2023