This year’s AVAC Report is about the new realities of biomedical HIV prevention research. In the last few years we’ve seen major advances, but also have had sobering realizations about the difficulties of developing new HIV prevention options that can succeed both in trials and programs in the real world. Landmark vaccine, microbicide and PrEP trial results energized the biomedical HIV prevention field. Yet, follow-up work from all these trials has been slower than necessary. In the search for new prevention tools for women two recent trials have found very low rates of adherence. These trials have given rise to important questions, not only about women’s willingness to use the test product, but about the research process itself.

We argue that the field needs to take a fast, focused look at fundamental assumptions and missed opportunities across the HIV prevention research field—and retool its approaches so that the next generation of research delivers advances that women and men want and will use.