This World AIDS Day, Putting the Power of Prevention in Women’s Hands

2010 has been a special year for women.

Brazil saw the election of its first-ever female president. Estimates of maternal deaths declined across the globe. Former Chilean President Michelle Bachelet was chosen to head a new United Nations agency on women, which will begin its operations in January 2011. And, excitingly, emerging technologies showed great potential to put the power of HIV prevention in women’s hands.

Woman-initiated prevention methods are key to the fight against HIV because they offer agency and protection to a disproportionally vulnerable demographic—women.

Globally, half of the people living with HIV and AIDS are female, and new infections in women and young people are growing rapidly, primarily through heterosexual sex. Biologically, women are more likely than men to acquire HIV. And gender inequalities and human rights violations heighten girls’ and women’s vulnerability; the use of physical force or emotional coercion during a sexual act greatly increases the risk of HIV transmission to the female, and violence and rape can further increase HIV risk by causing abrasions, bleeding, and tearing, especially among young girls whose genital tracts are not yet fully mature. Compounding this vulnerability, many girls and young women, especially the very young, cannot refuse unwanted sex or negotiate protection from pregnancy and STIs, including HIV, particularly when they fear retaliation.

Despite these grim realities, over three billion women and girls worldwide are HIV-negative. And they have the right to stay negative. Woman-focused HIV prevention efforts and technologies will ensure that women are able to do just that. When a woman cannot convince her partner to wear a male condom either because he is violent, intoxicated, ignorant, or because he just doesn’t want to, a woman-initiated method such as a female condom or microbicide gel provides her with essential protection she can initiate herself.

In July, news that results from a clinical trial in South Africa found a microbicide gel to be nearly 40 percent effective in protecting women against HIV during intercourse was received with great excitement by the global and women’s health communities, and with good reason; the advent and approval of a microbicide gel such as this would mean that women could protect themselves from HIV without a barrier method, which often requires the cooperation of a male partner. For many women, who are unable to negotiate condom use or refuse sex, even with their husbands, this means a gel that they can use without men knowing, and could mean the difference between remaining HIV negative or contracting the virus.

Scientists are continuing to develop this new technology to increase its effectiveness and usability. For now, there is one female-initiated HIV prevention method that is already available in many places and ready for women’s use: the female condom.

The female condom is, to date, the only woman-initiated protection method proven to be effective, both against HIV (94%- 97%) and unwanted pregnancies (87-95%). And women all over the world are taking note.

In Cameroun, the Society for Women and AIDS in Africa-Cameroun (SWAAC) has helped create widespread demand for female condoms. SWAAC now distributes over 150,000 female condoms each year—and intends to generate even greater demand in the future. Click here to watch a video on demand and distribution of female condoms.

This World AIDS Day, we have an opportunity—and a duty—to call for increased investment in these crucial technologies. More work must be done to ensure that female condoms are available and accessible to women: only one female condom is distributed for every 700 male condoms. And making microbicides widely available to women will require political will and additional funding. But with continued attention to and investment in these interventions, 2011 will see an even greater array of achievement by healthy, empowered women, to the betterment of their families, their communities, and the world at large.



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