Carol is in her mid-20s and raising her young daughter on her own. With very few economic options available to her she turned to commercial sex work when she was 21 years old. Every day she puts herself at risk of HIV, other STIs, and unintended pregnancy. Because of a USAID-funded campaign, Carol knows she needs to use condoms to protect herself but as a commercial sex worker she does not always have the negotiating power to do so.
Often at USAID we support the ABC approach- abstain, be faithful, and correct and consistent condom use. While these methods can be effective in preventing HIV transmission, often it can be difficult for women to negotiate prevention interventions. With women representing nearly 60 percent of those living with HIV in sub-Saharan Africa, it is imperative to find a method of prevention that can be initiated by women.
For almost 25 years, USAID has been on the frontlines of the HIV/AIDS epidemic. Our development programs have been cutting-edge, and have long put women at the center of programming. Gender, prevention of mother-to-child transmission, male circumcision, counseling and testing, nutrition, and HIV vaccine research are just some of the comprehensive array of HIV/AIDS prevention, care, and treatment programs administered through USAID.
Progressive programs continue today with the USAID-funded clinical trial, CAPRISA 004. The trial, which took place in South Africa, provided the first evidence that use of a vaginal gel, or microbicide, containing an antiretroviral drug (ARV) known as tenofovir can prevent HIV infection in women.
In the trial, tenofovir gel administered topically before and after sexual activity provided moderate protection in women at high risk of HIV infection. At the end of the study, researchers found that the use of 1% tenofovir gel by 889 women at high risk of HIV infection in Durban, South Africa proved the method to be 39 percent effective in reducing a woman’s risk of becoming HIV infected. The gel could be a unique HIV prevention tool for women who are not able to negotiate HIV prevention methods.
The successes of CAPRISA 004 ties in with the core principles of the U.S. Government’s Global Health Initiative (GHI). USAID is committed to a women- and girl- centered approach, creating a strong partnership with countries to sustain country ownership, and focusing on learning and accountability.
Once the results are confirmed through ongoing and future studies, USAID will work at every level to ensure women are able to access this unique form of prevention. This means Carol, and other women in developing nations, will have a form of protection against HIV that they can control and initiate. This new discovery puts the power of protection against HIV transmission in the hands of the woman and can ultimately save lives.