December 2006

An update on female-controlled methods for HIV prevention: Female condom, microbicides and cervical barriers

Matthews J, Harrison T. An update on female-controlled methods for HIV prevention: Female condom, microbicides and cervical barriers. The Southern African Journal of HIV Medicine.2006; 7(4):7-11

Worldwide, nearly 5 million new HIV infections occurred in 2005 with more than 3 million of these in sub-Saharan Africa. Despite declines in the HIV prevalence in some sub-Saharan African countries, many continue to be heavily affected.1 In Zimbabwe data have shown a decrease in prevalence from 22.1% to 20.1% since 2003, yet there is no sign of a similar trend in South Africa, where the adult prevalence rate is 18.8%.2 National-level prevalence rates, however, may not reveal the full impact of the epidemic on different populations. For example, 30.2% of pregnant women in South Africa attending public antenatal clinics in 2005 were HIV positive, with rates varying by province from 15.7% in the Western Cape to 39.1% in KwaZulu-Natal.3 In addition, female youth aged 15 - 24 years were three times more likely to be infected than young men in the same age group.

Women are increasingly bearing the burden of the epidemic. Of the 39 million people worldwide living with HIV/AIDS, half are women. UNAIDS estimates that of the new infections expected to occur between 2002 and 2010, 70% will be among women in the developing world.5 Several factors account for women\'s higher risk of infection, including biological, socio-cultural and economic factors. For instance, the female reproductive tract is more susceptible to HIV infection than the male reproductive system, and young women are at highest risk of HIV infection due to an immature physiology. Further, sexual violence and gender inequalities frequently play a role in women\'s and girls\' ability to practise safer sex.

Current HIV prevention methods are male-initiated or require a male partner\'s co-operation, leaving women without sufficient means to protect themselves from infection. New female-controlled prevention methods are urgently needed to reduce women\'s and girls\' risk of HIV infection. This article provides an update on currently available methods and others being tested and/or developed to provide women and girls with more HIV prevention options.