251510 Tenofovir Vaginal Microbicide Gel

Tuesday, November 1, 2011: 8:30 AM

David Kulick, MPH , Crescent City Beacon Initiative, Louisiana Public Health Institute, New Orleans, LA
Rebecca Alban , Tulane University School of Public Health and Tropical Medicine, New Orleans, LA
The 2010 phase II CAPRISA study in South Africa found that, with moderate adherence (60-80%), Tenofovir Gel reduced HIV transmission by 39% and genital herpes transmission by 51%. Tenofovir Gel offers women a self-administered option for HIV prevention and an alternative to the female condom. However, this product also faces a number of barriers to use related to cultural norms around sexuality, gender, and HIV/AIDS:

1. Among countries with the highest HIV incidence, there are significant cultural preferences regarding the “right” level of lubrication during sex. Women are reluctant to use vaginal microbicides if they perceive them to create undesired levels of lubrication, especially in societies that practice “dry” sex. 2. In patriarchal societies with pervasive gender disparities, male disapproval of vaginal microbicides often deters female use and can also lead to gender violence. 3. Stigma against people living with HIV/AIDS creates significant challenges for women seeking to access, store, and use products associated with HIV/AIDS, such as Tenofovir Gel. 4. In recent years, many large-scale funders of HIV/AIDS initiatives have shifted towards addressing root causes of HIV transmission (e.g., poverty, psycho-social needs, etc.) and away from medicinal interventions, such as microbicides.

Such social and political barriers create uncertainty for continued research, development, distribution, and use of Tenofovir Gel, which has significant potential to reduce the global spread of HIV.

Learning Areas:
Protection of the public in relation to communicable diseases including prevention or control
Provision of health care to the public
Public health or related research

Learning Objectives:
Describe recent data showing that the new mircobicide product, Tenofovir Gel, has the potential to reduce the incidence of HIV and STI transmission. Discuss the ways in which Tenofovir Gel provides an opportunity for female empowerment and yet also faces barrier to use due to cultural norms around gender roles and sexuality. Examine additional challenges to product development and distribution due to social discrimination against people living with HIV/AIDS and new trends in donor funding.

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I conducted the research for this presentation.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.