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New Prevention Technologies in HIV: What Would They Mean for Women?

Summer 2012

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Key Messages That We Can All Get Behind

When discussing the value of NPTs, we need to avoid over-simplifications of their (potential) link to "women's empowerment." Although NPTs may empower some women in some situations, they won't bring about universal sexual empowerment.

NPTs should not be seen as a "quick fix" solution nor should they distract attention from the need for social change and multi-level interventions that address gender inequality, poverty, and other forms of discrimination that make women more vulnerable.8,10 It is clear that NPTs will not have an impact unless the underlying social, economic, political and cultural conditions that make women more vulnerable in the first place are tackled. Addressing these conditions will also help remove the barriers that prevent women from using these new prevention options.

Therefore, NPTs must be offered within a comprehensive approach to HIV prevention -- one that balances structural changes (such as poverty reduction and gender equality), expanding and strengthening existing prevention strategies (such as behavioural interventions and the distribution of male and female condoms) and NPTs (such as PrEP and microbicides).

Frontline service providers and policy-makers need to understand the potential gender dynamics that will influence if and how women will use NPTs as they become available. Clearly, biomedical tools cannot replace women's sexual and reproductive autonomy, but they could provide the means by which women exercise such autonomy.


Resources

San Patten is a health research and evaluation consultant who has worked extensively on issues relating to injection drug use, the sex trade, and new HIV prevention technologies. San completed a master's degree in Community Health Sciences at the University of Calgary, is an adjunct professor in Sociology at Mount Allison University (specializing in social policy and non-profit leadership), and is a co-investigator of the Centre for HIV Prevention Social Research at the University of Toronto.


References

  1. O'Brien TR, Busch MP, Donegan E et al. Heterosexual transmission of human immunodeficiency virus type 1 from transfusion recipients to their sex partners. Journal of Acquired Immune Deficiency Syndromes. 1994; 7(7):705-710.
  2. European Study Group on Heterosexual Transmission of HIV. Comparison of female to male and male to female transmission of HIV in 563 stable couples. BMJ. 1992 Mar 28; 304(6830):809-13.
  3. Dunkle KL, Jewkes R. Effective HIV prevention requires gender-transformative work with men. Sexually Transmitted Infections. 2007 Jun;83(3):173-4.
  4. Youle M., Wainberg MA. Pre-exposure chemoprophylaxis (PrEP) as an HIV prevention strategy. Journal of the International Association of Physicians in AIDS Care (Chicago, Ill: 2002). Jul-Sep;2(3):102-5.
  5. PrEP Implementation Policy Forum: Developing Country-Level Participation and Capacity for PrEP Implementation [Internet]. Geneva: International AIDS Society; 2007 [cited 2010 Feb 5].
  6. Sawires S, Birnbaum N, Abu-Raddad L, Szekeres G, Gayle J. Twenty-five years of HIV: lessons for low prevalence scenarios. Journal of Acquired Immune Deficiency Syndromes. 2009;51(Suppl 3):S75-S82.
  7. Koo HP, Woodsong C, Dalberth BT et al. Context of acceptability of topical microbicides: sexual relationships. Journal of Social Issues. 2005;61(1):67-93.
  8. Mantell JE, Stein ZA, Susser I. Women in the time of AIDS: barriers, bargains, and benefits. AIDS Education and Prevention. 2008 Apr;20(2),91-106.
  9. Hoffman S, Morrow KM, Mantell JE et al. Covert use, vaginal lubrication, and sexual pleasure: a qualitative study of urban U.S. women in a vaginal microbicide clinical trial. Archives of Sexual Behavior. 2010 Jun; 39(3):748-60. Epub 2009 Jul 28.
  10. Mantell JE, Dworkin SL, Exner TM et al. The promises and limitations of female-initiated methods of HIV/STI protection. Social Science and Medicine. 2006 Oct;63(8):1998-2009. Epub 2006 Jul 11.
  11. Tolley EE, Severy LJ. Integrating behavioral and social science research into microbicide clinical trials: challenges and opportunities. American Journal of Public Health. 2006 Jan;96(1):79-83. Epub 2005 Nov 29.
  12. Tanner AE, Fortenberry JD, Zimet GD et al. Young women's use of a microbicide surrogate: the complex influence of relationship characteristics and perceived male partners' evaluations. Archives of Sexual Behavior. 2010 Jun; 39(3):735-47. Epub 2009 Feb 18.
  13. Woodsong C. Covert use of topical microbicides: implications for acceptability and use. Perspectives on Sexual and Reproductive Health. 2004 May-June;36(3):127-131.
  14. UNAIDS. UNAIDS Report on the global AIDS epidemic. 2010.
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This article was provided by Canadian AIDS Treatment Information Exchange. It is a part of the publication Prevention in Focus: Spotlight on Programming and Research. Visit CATIE's Web site to find out more about their activities, publications and services.
 

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