Humankind has been besieged throughout its evolution by microorganisms that pose a continual challenge to the survival of the species. The pandemic, the acquired immunodeficiency syndrome (AIDS), is due to a newly recognized microbe, the human immunodeficiency virus (HIV). As we prepare to enter the new millennium, it is appropriate to reflect on the origins of this epidemic, what has occurred over the past 18 years, what has been accomplished from a scientific and public health perspective, and what the prospects are for the future. With growing recognition of the potential value of microbicides for HIV prevention, the importance of the acceptability of this new technology has been widely acknowledged. We review the current body of microbicide acceptability research, characterize the limitations in assessment approaches, and suggest strategies for improvement. As acceptability is likely to be a key determinant in the useeffectiveness of microbicides, this includes exploring the effects that sexual partners, health care providers, and key opinion leaders have on the acceptability of microbicides among women and men, including youth and people living with HIV. According to the Joint United Nations Programme on HIV/AIDS, there are more than 40 million people living with HIV, and more than 15,000 new infections occur every day. One approach to curbing HIV is the development of topical microbicidal agents or microbicides. These are compounds designed to protect the body’s mucosal surfaces from infection by sexually transmitted disease causing pathogens, including HIV. Several candidates are in preclinical stages; however, only a handful have been tested in humans for safety, and even fewer are ready for clinical efficacy trials
