The female genital tract environment represents an intricate interplay between commensal microbes, pathogens, small molecule metabolites and host immune cells resulting in health and disease consequences for women, their sexual partners, and neonates. Refined characterization of the genital tract using sophisticated methods has expanded our understanding of mucosal immunology, the microbiome, the metabolome, and the proteome. Mechanisms leading to adverse outcomes, particularly elevated risk of HIV acquisition, are being unraveled, and an increasing number of interventions are in clinical trials. In this meeting, we will examine cutting-edge knowledge needed to tackle some of the most challenging global problems in reproductive and sexual health, including current understanding of female genital tract microbiology and immunology, and advances in therapeutics and preventatives intended to modify or protect these environments. Potential mechanisms leading to adverse outcomes, and prospective prevention and/or treatment interventions will be presented and discussed. Pathways for development of novel interventions, including industry partnership and regulatory strategies will be considered. The progress made in recent years at the bench and in clinical trials should inform global health interventions aimed at sustaining sexual and reproductive health for women especially in resource-limited settings, where women suffer the most severe consequences of these challenges.