The most recent estimates indicate that in 2011, 34 million people were living with HIV, the majority in sub-Saharan Africa. Even though the estimated number of new infections is decreasing, there remains an urgent need for new prevention technologies, particularly those controlled by women and men who have receptive sex. Microbicides are products designed to be applied vaginally or rectally to prevent acquisition of HIV and other sexually transmissible infections and, as such, provide a great hope for female-controlled HIV prevention. Oral prevention drugs are a more recent development that also has great potential. The field changed radically in 2010-2011 with the first trials demonstrating effectiveness of a microbicide and oral prevention drugs. The seventh biannual Microbicides conference, which took place in Sydney, Australia, in April 2012, was the first conference in this series since these new results and represented a transition from the discovery phase of research to considerations of implementation. Researchers, advocates, community representatives, funders and the media came together over 3 days to talk about the realities of implementation, particularly in regard to challenges in adherence and funding, and also examined early findings for new prevention technologies. This report of the 2012 International Microbicides Conference provides a summary of recent developments and ongoing challenges in the field of microbicides research.