Violence Against Women, HIV and Microbicides
Violence and HIV -- both are potentially deadly and both have persistent negative effects on health and well-being. Multiple factors put women in violent relationships at increased risk of becoming infected with HIV and other sexually transmitted infections (STIs), including:
What Are Microbicides?
Microbicides: (mi-KRO'-bi-sidz) are products being developed to prevent the sexual transmission of HIV and other STIs when applied in the vagina or rectum. They are likely to come in a variety of forms such as a gel or cream inserted with an applicator, a sponge or time-released suppository, or an intra-vaginal ring that could potentially be used for months at a time.
Will Microbicides Also Work as Birth Control?
Some of the microbicides being investigated will prevent pregnancy and some will not. "Dual-action" contraceptive microbicides could provide both pregnancy and disease prevention to women wishing to meet both needs with one product. They would also offer a much-needed alternative to women choosing not to use hormonal birth control methods like pills or patches.
But we also need non-contraceptive microbicides. With condoms, women have to choose between childbearing and HIV prevention. Access to a non-contraceptive microbicide would give women a third option -- one that blocks infection but still allows pregnancy to occur.
Will They Protect Against All STIs?
Although protection against HIV is the primary goal, each microbicide under development is tested against a range of common STIs. Several products appear capable of reducing risk of at least one or two other STIs, in addition to HIV. No one microbicide will be effective against all possible infections. But it is very likely that "broad-spectrum" microbicides, capable of preventing HIV and least a handful of other STIs, can be developed.
Will a Woman Be Able to Use a Microbicide Without Her Partner Knowing About It?
The first microbicides will probably come in gels or creams -- products that will increase vaginal lubrication somewhat. This may make using them secretly a bit of a problem for women in long-term partnerships. Second- and third-generation microbicides, however, are being formulated in ways that may minimise this effect. A flexible, microbicide-loaded vaginal ring, for example, could provide time-released protection with minimal lubrication change, thus meeting the needs of women who can't or don't want to discuss the issue of protection with their male partners.
A woman who can't safely raise the topic of HIV or STI risk with her partner may choose to claim that she is using the product for hygiene or sexual enhancement rather than for disease prevention. The substantial market for "vaginal cosmetics" of all types (such as douches and deodorant sprays) is problematic from a health standpoint. But it does show products are used in all parts of the world already and, hence, offer a ready excuse to the woman in need of a pretext for her microbicide use.
Why Aren't Microbicides Available Now?
Scientists have identified over 50 potential microbicides and are testing them to find out which ones could be safe and effective for regular use. Unfortunately, not enough public funding is available to move their research along efficiently. Getting a microbicide on the shelves in the near future doesn't depend as much on the speed of scientific progress as it does on increasing the level of funding to support research, development and access. If we want microbicides, we have to demand sufficient governmental funding to develop them without delay.
Microbicides and Safety Planning
With microbicides, women could reduce infection and unwanted pregnancy risk, even in the context of forced unprotected sex. Women living with HIV could lower their risk of re-infection and minimise their already heightened vulnerability to STIs and vaginal infections. For HIV negative women, microbicides offer the hope of leaving an abusive relationship still uninfected. Women living with domestic violence struggle every day to regain control over their own bodies and futures. Microbicides could become one more tool for achieving that goal.
This article was provided by Global Campaign for Microbicides. Visit the Global Campaign for Microbicides' website to find out more about their activities, publications and services.