Tenofovir Vaginal Microbicide Gel

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.