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HIV/AIDS is not gender neutral; the disease disproportionately affects women. Biologically, the virus is more easily passed from man to woman, but even more problematic is the fact that women are often marginalized and discriminated against in ways that deprive them of their agency in choosing when, how and with whom to have sex. Recent studies in India, for example, showed that one of the most at-risk groups for new HIV infection were married women in monogamous relationships with unfaithful husbands. These women are often unable to protect themselves: if they request that their husbands use condoms or even withhold sex, they risk being abandoned by their husbands and ostracized by their communities.
Given these facts, I was extremely excited to hear Bill and Melinda Gates call for vast increases in funding for microbicide research in their keynote address (.pdf) at the opening session of the International AIDS Conference in Toronto. Microbicides -- defined by the International Partnership for Microbicides as "vaginal products being developed to reduce the transmission of HIV during sexual intercourse" -- hold out the hope of allowing women to protect themselves against AIDS without the consent of their partner.
Currently, a variety of microbicides are being developed as gels, creams, sponges and other forms. Sixteen microbicides are being clinically evaluated and the hope is that one of these products will be widely available for distribution by 2010. These microbicides do have their drawbacks -- including the fact that they do not provide 100% efficacy in preventing the transmission of HIV/AIDS -- but in the absence of an effective AIDS vaccine, the development of microbicides could be the key breakthrough that helps stop the spread of HIV while empowering the people who are most affected by the disease: women. As Bill Gates rightly stated in his keynote speech:
We need tools that will allow women to protect themselves. This is true whether the woman is a faithful married mother of small children, or a sex worker trying to scrape out a living in a slum. No matter where she lives, who she is, or what she does -- a woman should never need her partnerâ€™s permission to save her own life.
Let's hope that this call for increased attention to microbicide research will lead to accelerated development of these potentially life-saving products for women.
CGD blog posts reflect the views of the authors, drawing on prior research and experience in their areas of expertise. CGD is a nonpartisan, independent organization and does not take institutional positions.