The dominant discourse around the development of microbicides so far has centred on the advantage of it being a female controlled prevention method. Consequently, microbicides have been marketed as a ‘magic bullet’ to meet women’s unmet medical needs – availing a degree of independence when it comes to making choices, including protection from sexual infections, without the need to address structural barriers to gender equality in society.
This was an issue discussed at a seminar at the Institute of Development Studies (IDS) this week on Gender and Technology in HIV Prevention Research by Catherine Montgomery from the University of York.
However, what emerged from the Ms. Montgomery’s research, following her interviews and focus group discussions with participants in a microbicide trial in Zambia, was that women are not usually passive objects using ‘stealth products’ for protection; but used the trial to strategically engage their partners in discussions on condom use, pleasure and safer sex. The use of microbicides by interviewees was often a joint endeavour between couples.
Catalyst for desire
A major attraction of the microbicide was that, due to its viscosity, it was seen as a lubricant, which made the vagina wet enough to enable pleasurable sex for men and women. Ms. Montogomery’s contention was that viewing microbicides as ‘a catalyst for desire’ could, in future, be a very compelling motivation for individuals , and couples to use them for safer and pleasurable sex. This would move away from an unfavourable notion of microbicides as a tool for women in generalised epidemics who are disempowered and passive victims of male sexual predators. For women and their sexual partners, microbicides may indeed provide a technology for sexual health and sexual fulfillment, ultimately contributing to the well-being of their families.
Sex positive attitude
These findings were very interesting in that they highlighted again the importance of paying attention to pleasure and sex positive attitudes in HIV and SRH programming and policy work – often missed when using a more bio-medical approach to safer sex. A sex positive approach to our Sexual and Reproductive Health Rights (SRHR) and HIV work is highlighted in the Good Practice Guide on Integration of HIV and SRHR and our good practice programming standards.
Regrettably, this research was limited to established heterosexual couples, and it would be interesting to observe how motivations for using a microbicide may vary with individuals with multiple sexual partners, those engaged in transactional sex and/or have sex with partners of the same sex.
If microbicides were to eventually become a viable prevention method, it could have an advantage over current prevention technologies with regards to safer pleasurable sex, such as male and female condoms which are often perceived as non-pleasurable.
For more information on the Alliance’s approach, refer to our Good Practice Guide on the integration of HIV and sexual and reproduction health and rights and our good practice HIV programming standards.