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One of the earliest alternative strategies evaluated for the prevention of HIV was the use of nonspecific microbicides. These topical products were designed to prevent sexual transmission of HIV through the vaginal or rectal route and, in some cases, to also prevent pregnancy. Products that were evaluated included the anionic polymers cellulose sulfate and PC-515, the surfactant C31G, and PRO 2000. Great effort was put into the development and evaluation of these agents; nearly 20,000 HIV-negative women participated in randomized, placebo-controlled trials. However, as summarized in Table 2, none of these nonspecific products has demonstrated any level of effectiveness in reducing HIV infection in women. These data suggest that it requires ARV-containing products with high potency against HIV to have a significant impact on HIV acquisition.
Table 2. Outcomes of Microbicide Effectiveness Trials
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