Partnering to Promote Female-controlled HIV Prevention Methods

1. Presentation at Women’s Networking Zone, International AIDS Conference 2006, Toronto, Canada Female Condom Microbicides Diaphragm AIDS Vaccine Partnering to Promote Female-controlled HIV Prevention Methods Matthews J, Becker J, Massey C, Jacobsen J, Patel B Ibis Reproductive Health, International AIDS Vaccine Initiative, Center for Health and Gender Equity, Global Campaign for Microbicides Current Efforts and Next Steps Impact of Partnership Partners: Who and Why? • In 2006, Ibis, GCM, IAVI and CHANGE presented at the International AIDS conference, resulting in a dynamic conversation with the audience. Since then, a more formal partnership has been established to explore opportunities for collaboration. In December 2006, the partners hosted a meeting in New York for 25 participants from a range of organizations. Next steps include: • Explore the possibility of holding regional information sharing sessions with other organizations at upcoming conferences in Africa, Asia and Latin America. • Develop a 2-page fact sheet on female-initiated and -controlled methods to share among groups. • Continue mapping exercise of organizations’ activities to identify potential opportunities for collaboration. • This formalized partnership has: • strengthened each group’s ability to underscore in the HIV discourse women’s and girls’ need for choices; • provide direction to advocates despite an unknown timeline for availability of these methods; • advocate for greater attention and funding while avoiding competition for resources; • develop supportive messages without undermining another method; and • tailor messages to reach policy makers, providers, researchers, advocates, women and girls. • Ibis Reproductive Health (Ibis) • Global Campaign for Microbicides (GCM) • International AIDS Vaccine Initiative (IAVI) • Center for Health and Gender Equity (CHANGE) • These research and advocacy organizations have joined together to share information, coordinate advocacy efforts, and act as a unified force to advocate for a range of HIV prevention methods – female condom, microbicides, vaccines, cervical barriers - to meet the needs of women and girls. Each group works closely with international partners from the grassroots to the global level. Why multiple options? Conclusions Given their increased vulnerability due to social, biological and socio-economic factors, women and girls need a range of female-controlled/initiated HIV prevention methods. • Current female-initiated options are limited. • Potential methods are expected to be available at various times and will likely be partially effective. • Disproportionate impact on women worldwide.  In sub-Saharan Africa, more than two thirds of young people living with HIV are women. • A range of choices increases the likelihood of women and girls adopting a strategy appropriate to their needs. Stakeholders must continue to identify opportunities to share knowledge and develop consistent, mutually supportive messages. These fields are jointly advocating for greater attention and investment in multiple methods to meet the needs of women and girls as part of a comprehensive global response. Collaboration is essential to ensuring women’s access to a range of HIV prevention methods. Female-controlled Methods Microbicides Female Condom • Substances that prevent the sexual transmission of HIV and other sexually transmitted infections when applied in the vagina or rectum. • Could be produced in many forms, including gels, creams, suppositories, films, or as a sponge or ring that releases the active ingredient over time. • Microbicides are still in the testing phase, and are not yet available. • 10 products have proven safe and effective in lab and animal tests, and are now being tested in people. • First generation will likely be 50-60 percent effective. • Only existing female-initiated method for HIV prevention; can reduce the rate of HIV transmission among women having sex with an infected partner by more than 90 percent. • Can be used to avoid unintended pregnancy. • Studies from 40 countries show that acceptability rates for female condoms range between 37 and 93 percent of potential users. • Access to female condoms increases the rate of use of both male and female condoms, increasing the rate of protected sex overall. • Increased access to female condoms can lead to dramatic savings in both lives and in health care costs. AIDS Vaccine Cervical Barriers • Historically, vaccines have been one of the most effective public health interventions to prevent disease. • Today, there are over 30 AIDS vaccine products in human clinical trials and more candidates in various stages of pre-clinical development. • Can be used with or without a partner’s cooperation – may be particularly relevant for adolescent girls. • Likely to be less effective than current vaccines for other diseases; current vaccines are typically 80-90 percent effective. • Cervical barriers (diaphragms and cervical caps) are latex or silicone cups that fit at the upper end of the vaginal tract, covering the cervix. • When used with spermicide, they are 68-94 percent effective against pregnancy. They are safe, have very few side effects and have a long history as contraceptives. • The diaphragm is currently being tested with a lubricant gel as a potential tool for reducing heterosexual transmission of HIV among women.