An arsenal of promising new HIV prevention methods was heralded in a report released at the International AIDS Conference in Toronto on Tuesday, but the authors of the report warned that the new techniques can't help if access these methods remains elusive for those who need it most.

The report was co-convened by the Henry J. Kaiser Family Foundation and the Bill & Melinda Gates Foundation. It said that prevention approaches such as male circumcision and microbicides could only have an impact on slowing the spread of HIV if access to both old and new methods becomes widespread for everyone at risk.

"If we can't do a good job of scaling up what we know works today: testing, condoms, access to information, education, that's a sober reminder that we might not be able to bring the new things that we're very excited about up to scale," Jennifer Kates, director of HIV policy at the Kaiser Foundation, told CTV Newsnet Tuesday.

The bottom line, she said, "is that even if we see that a microbocide is effective or we find a vaccine in many years or male circumcision works, no one thing is going to end HIV."

Information on both old and new prevention methods needs to be aimed at those at high risk.

"We've come very far in 10 years but we still have not won the battle against HIV," said Kates. "There are four million new infections worldwide every year."

The report, New Approaches to HIV Prevention: Accelerating Research and Ensuring Future Access, was released at the International AIDS Conference in Toronto by the Global HIV Prevention Working Group on Tuesday.

It chronicles the progress research has made in six promising new methods of HIV transmission prevention:

• Male circumcision
• Cervical barriers, such as diaphragms
• Daily administration of antiretroviral drugs currently used for HIV treatment
• Suppression of herpes, which increases HIV risk up to three times
• Topical microbicides
• HIV vaccines

The report noted that although male circumcision has shown to be effective at reducing transmission in clinical trials, circumcisions must be safely implemented by trained health providers and many developing countries lack sufficient qualified personnel.

Major new donor funding is needed to purchase equipment, train care providers, conduct education campaigns and monitor effectiveness, without taking funding away from current AIDS programs, the report said.

The experts who wrote the report also warned that the introduction of new prevention approaches can lead to complacency, which could increase risky behaviour that leads to an increase in infections.

No one HIV prevention method is 100 per cent effective, so public health officials need to emphasize combining new strategies with old ones such as modifying behaviour, using condoms, HIV testing and treatments for other sexually transmitted diseases, the report said.

There is new hope for a vaccine, thanks to research that has gotten a big boost from the Bill and Melinda Gates Foundation, which has provided 16 grants totaling $287 million US to a network of researchers who agree to collaborate and share information on vaccine development.

But a vaccine is still years away and research for it and other new methods face significant hurdles, the report said. Capacity to conduct clinical trials is limited due to an inadequate number of participants, equipped labs and trained staff. Current trials involve about 80,000 participants but thousands more are needed.

The report recommended that UNAIDS and the World Health Organization develop ethical guidelines for research, since there is no consensus on which prevention methods should be provided to all participants, or how to provide access to treatment for those who are infected.

Greater communication between researchers and care providers in the field is also recommended, to ensure success of critical prevention studies, the report said.

Kates stressed that information on existing techniques isn't getting to some of the people who need it most.

"The bottom line is that even if we see that a microbicide is effective or we find a vaccine in many years or male circumcision works, no one thing is going to end HIV," said Kates.

"We have to combine them and work with the existing things plus the new things on the horizon to really make an impact."