In 2004, Laurel Lagenaur was struck by a report from the United Nations showing that HIV was increasingly infecting women, who accounted for nearly half of the 38 million adults living with HIV worldwide1. Until then, researchers in the US had considered the disease to strike primarily men who had sex with men. As the director of research at Osel, a biotech start-up based in Mountain View, California, Lagenaur began to ponder ways to address the growing crisis. The company, whose mission is to genetically engineer commensal bacteria to be more beneficial to health than they naturally are, learned of proteins that inhibit HIV from binding to cell surfaces. So, it started to explore ways of manipulating bacteria to express these molecules.

NATURE MEDICINE VOLUME 23 | NUMBER 1 | JANUARY 2017

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