The future of female‐controlled barrier methods for HIV prevention

Female condoms and lessons learned

Dados Bibliográficos

ID15098326
AutoresA Kaler (0000-0003-2681-3483, autor correspondente)
Ano2004
Volume6
Fascículo6
Páginas501-516
Data de publicação2004-11-01
Peer ReviewedSim
Open AccessNão
TipoARTICLE
PeriódicoCulture Health & Sexuality (JOURNAL)
Identificadores do periódicoISSN: 1369-1058 • E-ISSN: 1464-5351
EditoraInforma UK Limited (PUBLISHER • GB)
DOI10.1080/13691050410001701948
OpenAlexW1993841554
IdiomaEN
Citações recebidas6
Referências citadas12

In the context of HIV/AIDS, there is increasing interest in female controlled barrier methods. HIV prevention suffers from a critical 'technology gap': namely, the lack of products to enable women to reduce their own risk of sexually transmitted infection, independent of their male partners. An ideal technology should be low‐cost, free of side effects, effective against both HIV and other STIs, and undetectable by male sexual partners. A first generation of barriers is already in circulation: namely, female condoms (FCs). But what can we learn from FCs that will help to increase the chance that programmes focused on other barrier methods will be successful? This paper draws on lessons from the past decade of FC programming. Interviews with 34 professional stakeholders in FC programming from the USA and South Africa highlight a number of factors that can help create public and institutional cultures, in which barrier methods can be considered feasible and can be put into use. Notes Amy Kaler is an assistant professor in the Department of Sociology at the University of Alberta, Canada. All correspondence should be addressed to: Amy Kaler, Department of Sociology, University of Alberta, 5–21 HM Tory Building, Edmonton, Alberta, T6G 2H4, Canada; e‐mail [email protected] 1Early assessments of the acceptability of diaphragm use for HIV prevention in the USA have also been positive (Harvey et al. Citation2003). 2In the USA, the percentage of women relying on diaphragms for contraceptive protection has dropped from 5% in 1988 to 2% in 1995 (Schwartz and Gabelnick Citation2002: 310). 3Because the world of HIV prevention programming is small and because reputations and careers may be affected by participants' comments, I have chosen not to provide any details about the participants. This choice will make it difficult for readers to contextualise and thus to evaluate the opinions put forward here, but will protect the people who spoke with me. 4Chaya et al. (Citation2002: 33) estimate that 'an investment of $10 million in female condoms would protect no fewer than 20 million sex acts, reduce the unit cost by 25% and support dozens of country, regional and community programmes'. 5Re‐use is not likely to be a major issue with the next generation of barrier methods, which are either intended for multiple uses, such as diaphragms and cervical caps, or structurally impossible to re‐use, like microbicides. Resumé Dans le contexte du VIH/sida, il existe un intérêt croissant pour les méthodes féminines de prévention. La prévention du VIH souffre de graves «insuffisances technologiques», à savoir le manque de techniques permettant aux femmes de réduire les risques liés aux infections sexuellement transmissibles, indépendamment de leurs partenaires masculins. La méthode idéale devrait être de faible coÛt, sans effets secondaires, efficace à la fois contre le VIH et les autres IST, et indétectable par les partenaires sexuels masculins. Une «première génération» de méthodes de barrière est déjà en circulation: les préservatifs féminins. Mais comment les connaissances sur le préservatif féminin nous aideront‐elles à améliorer l'efficacité des programmes centrés sur d'autres méthodes de barrière? Cet article s'inspire des leçons tirées des programmes de promotion du préservatif féminin sur la dernière décennie. Des entretiens avec 34 intervenants dans ces programmes, originaires des USA et de l'Afrique du Sud, mettent en avant un certain nombre de facteurs susceptibles de créer une culture publique et institutionnelle, dans lesquelles des méthodes de contrôle peuvent être considérées comme réalisables et mises en application. Resumen En el ámbito de VIH/sida, se observa cada vez más un interés por métodos de barrera controlado por mujeres. La prevención de VIH adolece de un serio "vacío tecnológico": es decir, la falta de productos con los que las mujeres sean capaces ellas mismas de hacer disminuir el riesgo de infección por transmisión sexual, independiente de sus compañeros masculinos. Una tecnología ideal debería tener un bajo coste, no tener efectos secundarios, ser eficaz contra el sida y otras enfermedades de transmisión sexual y no ser detectado por los compañeros sexuales masculinos. Una "primera generación" de barreras ya está en circulación: se trata de los condones femeninos. Pero ¿qué podemos aprender de los condones femeninos para que se aumente la posibilidad de que los programas enfocados en otros métodos de barrera tengan éxito? Este documento se basa en las lecciones de la última década en lo tocante a los programas enfocados en el uso del condón femenino. Las entrevistas con 34 profesionales especializados en programas de condones femeninos de Estados Unidos y Sudáfrica destacan varios factores que pueden servir para crear tradiciones públicas e institucionales en las que los métodos de barrera se consideren eficaces y puedan ser utilizados. Additional informationNotes on contributorsAmy KalerFootnote Amy Kaler is an assistant professor in the Department of Sociology at the University of Alberta, Canada. All correspondence should be addressed to: Amy Kaler, Department of Sociology, University of Alberta, 5–21 HM Tory Building, Edmonton, Alberta, T6G 2H4, Canada; e‐mail [email protected]

Family medicine · Geography · Political science · Public relations · Adolescent Sexual and Reproductive Health · HIV/AIDS Research and Interventions · Medicine · Sex work and related issues · Gerontology