HIV Prevention for Women: Important now more than ever

Micro-Card 1104-FN Microbicides for Women


In 2013, Sonke Gender Justice, in partnership with fhi360, conducted a Gender Analysis for Microbicide Introduction in South Africa. We interviewed nearly 40 stakeholders from across civil society, academia, government, donor organisations and health care institutions in order to find out what the pressing issues were around women’s rights and gender equality for the rollout of a vaginal microbicide gel that, hopefully, will be ready to rollout in South Africa within the next two years. As we think about International Day of Action for Women’s Health and demand that women’s health and human rights are holistically and inclusively included in the post-2015 agenda, ensuring that adequate attention, resources, and work around HIV prevention for women is critical.

However, it is also important to note that while women are much more likely to be infected by HIV, men are much more likely to be doing the infecting, not getting tested, and not adhering to treatment nearly as well as women. This is a combination of factors that includes structural barriers around access to care for men as well as risky sexual behaviours and avoidance of access health care that result from notions of masculinity that link risk-taking with manhood. As such, HIV prevention and treatment must also include substantial resources to engage men around their own health, HIV prevention and gender equality.

Key findings of our Gender Analysis for Microbicide Introduction:

1. Microbicides should be made available to all women, and not just high-risk populations. However, women in steady partnerships and youth are key populations to reach.

2. Marketing should “normalize” microbicides to create an enabling environment for women to use the product.

3. Microbicides should be integrated into existing health services and programs.

4. Microbicides should be made available free-of-charge in public health facilities, but additional costing and branding options should also be made available to cater to the diversity of women.

5. Microbicide promotion should be sex-positive and highlight pleasure.

6. Messages on microbicides should reach couples, in addition to women.

7. Women have the right to choose whether they inform their partner of their microbicide use, and health providers need to support them in making the decision that is appropriate for them.

8. Providers need to be equipped to identify, support, and refer women experiencing partner violence.

9. Men should be positively engaged to help increase microbicide acceptability and adherence and promote couples’ communication and relationship quality.

10. Microbicides have the potential to empower women, but underlying gender norms and power imbalances need to be challenged for real changes in gender equality to occur.

11. Microbicides are strongly linked to issues of sex, sexuality and women’s health. Working within spaces created for women (such as stokvels and other women’s groups) to introduce microbicides may create opportunities for women to have broader conversations on all of these topics.