Numerous international conventions, agreements, laws and declarations recognise that the right to the highest attainable standard of health is universal and includes the right to reproductive and sexual health. This means that all people are entitled to enjoy a mutually satisfying and safe relationship, free from coercion and violence and without fear of infection or unwanted pregnancy.1 The right to protect oneself from HIV infection is surely an integral part of the rights to health and reproductive freedom.
Reproductive and sexual rights are most clearly articulated within the Programmes of Action of the UN International Conference on Population and Development (Cairo, 1994), the UN Fourth World Conference on Women (Beijing, 1995) and the Declaration of Commitment on HIV/AIDS (UNGASS, 2001).
In Cairo, governments recognised the need to bring new, safe, affordable and effective methods of HIV prevention to fruition and pledged to pay particular attention to microbicides.
At the Beijing conference, the international community recognised that barriers to women's health include inequality as well as inadequate responsiveness to women's needs.
In the UNGASS Declaration, governments agreed to empower women to have control over their sexual lives and increase their ability to protect themselves from HIV infection.
In addition to the commitments made by governments in these declarations, the International Guidelines on HIV/AIDS and Human Rights require nation states to ensure access to affordable medications and preventive technologies.2 They further note that this duty is shared among nations, and that wealthy nations have an obligation to assist less wealthy nations in realising the right to health.
Microbicides are user-controlled substances designed to prevent the sexual transmission of HIV and possibly other sexually transmitted pathogens when applied in the vagina. Some microbicides may also help prevent disease transmission when applied to the rectum. These products will take the form of gels, creams, suppositories, lubricants -- even long-acting forms such as vaginal rings.
Scientists are pursuing over 50 product leads. Three are in advanced testing to measure their effectiveness. If one of the three candidates that are currently in advanced clinical trials proves to be effective, a microbicide could be ready for introduction in a handful of countries, through smaller scale introductory programmes in the next 5 years. If the current set of products does not prove effective, the time horizon will be longer. (although there are several second-generation leads already in human testing). Safe and effective microbicides would help protect human, reproductive and sexual rights of women worldwide.
We have the right to protect ourselves and our families.
Microbicides will benefit women, men, and children
- Millions of women are unable to insist on partner fidelity or abstinence -- and cannot control condom use
- Men and women are both in danger of contracting HIV and STIs when having sex with infected partners
- 15 million children are orphans because their parents died of AIDS3
- Will give women a way to reduce their own risk of infection when they cannot insist on condom use
- May provide bi-directional protection for men having sex with partners who are HIV positive or have STIs
- Will help protect the well being of children by helping to reduce their parents' risk of infection
We have the right to get pregnant without fear of disease.
Microbicides are being developed in contraceptive and non-contraceptive forms
|At Present||Non-Contraceptive Microbicides Will|
- If your partner is infected, you can either abstain from sex or use a condom. Neither of these options allows pregnancy to occur.
- If you have unprotected sex in order to get pregnant, you and your future children may become infected
- Help protect you from HIV and STIs while still allowing you to conceive a child
- Help protect your future children from being born with HIV and/or other STIs
- Provide you with additional tools for making safe, informed reproductive choices
We have the right to more and better contraceptive options.
Some candidate microbicides appear to be "dual acting," preventing unwanted pregnancy as well as disease
|At Present||Contraceptive Microbicides Will|
- Condoms are the only birth control option that also protects against HIV
- Our birth control options are limited. Contraceptives either have to be applied at the time of sex, or are hormonal and must be prescribed by a physician
- In long-term relationships, consistent condom use rates tend to be very low
- Offer protection against both unwanted pregnancy and disease
- Offer a contraceptive option that is non-hormonal, non-irritating, and will not interfere with intimate contact
- Be usable with condoms or hormonal contraceptives for back-up protection
- Provide contraceptive protection and reduce risk of infection when condoms are not being used
We have the right to sexual pleasure and enjoyment.
Microbicides can enhance sexual pleasure
|At Present||Microbicides Will|
- Worrying about HIV and other sexually transmitted infections can reduce sexual pleasure
- Some people feel that condoms interfere with sexual pleasure
- Allow you to enjoy sex with less fear of becoming infected4
- Provide lubrication thereby enhancing sexual pleasure and enjoyment
- Be applied before sex to prevent interruption
IPPF Charter on Sexual and Reproductive Rights 1996
International Guidelines on HIV/AIDS & Human Rights Revised Guideline 6: Access to Prevention, Treatment, Care and Support (UNAIDS 2003);
Henry J. Kaiser Family Foundation HIV/AIDS Policy Fact Sheet: The Global HIV/AIDS Epidemic, December, 2004.
The first generation of microbicides on the market are expected to be 50-60% effective -- nowhere near as protective as condoms but far more protective than nothing when used by people who aren't using condoms. Later generations of microbicides to reach the market are hoped to have effectiveness rates as high as 80-90%.