KHOPOTSO: In South Africa alone, it’€™s estimated that the prevalence rate of HIV infection among women is 12.8%. Women also account for more than half of South Africans infected with HIV, as they make up 55% of the almost 6 million individuals reported to be living with the virus. Various factors, which have at the core, a die-hard culture of denying women their rights, particularly sexual rights, are responsible for this.  

ZANELE HLATSHWAYO:

Beijing’€™s Conference Paragraph 96 defines sexual rights as women’€™s rights to have control over, and decide freely and responsibly on matters related to their sexual and reproductive health, free of coercion, discrimination and violence. Paragraph 96 strongly advocates for shared responsibility between men and women, and calls for mutual respect in sex-related matters and consequences.

KHOPOTSO: Zanele Hlatshwayo, Programme Manager for Sexual Health and Rights at the Women’€™s Health Project, in Johannesburg. But since Beijing, has the ideal of sexual rights become a reality for most women? In South Africa we know that that’€™s far from the truth for many women because we have high levels of rape, domestic violence, HIV and AIDS and other STI’€™s as well as teenage and unwanted pregnancies. Despite the knowledge that it’€™s an almost readily available form of contraception and barrier to disease, some men have resisted the male condom, thus putting at risk the lives of their partners. This has led to a rising need for female-controlled methods of disease prevention, like the female condom. But in many developing countries, including in South Africa, access to this form of protection is still inadequate.    

Dr NOMONDE XUNDU:

Female condoms are freely available in the public sector, but perhaps not to the same extent as male condoms are, mainly because of cost constraints… But we have defined high-risk areas where the Femidom is freely available’€¦ It’€™s mainly commercial sex workers, and districts themselves would define pockets of high-risk areas whereby, we would as national Department then support them by providing the Femidoms.      

KHOPOTSO: Dr Nomonde Xundu, of the Department of Health. Efforts to develop a vaccine ‘€“ the ultimate hope in preventing new HIV infections ‘€“ should also take into account that any vaccine developed should be effective in both women and men. Dr Samuel Kalibala is the Regional Representative of the International AIDS Vaccine Initiative (IAVI) in the East and Southern African region.

Dr SAMUEL KALIBALA:

When you look at some studies that have been examining the efficacy of vaccines, some suspicion comes up to suggest that maybe there is a gender variation in terms of the protectiveness of the vaccine. I can summarise two of them. One is a study to test a vaccine against Herpes Simplex Virus. This study found that the vaccine had 75% protectiveness for women, but no protectiveness for men. That conclusion cannot be confirmed until we have enough samples of women. Unfortunately, in that study there were few women. Another study where again, there was some suggestion of difference in protectiveness is the Vax-Gen trial of HIV vaccine, a Phase 3 trial where 5 500 people were recruited, but only 309 of them were women. But they found that 2.7% of the men got infected, but only 0.8% of the women got infected. This suggests, again, that the vaccine might protect women more than it protects men. But again, it is a suggestion, and it can only be confirmed when we have a large enough sample of women’€¦ This is a very important warning sign for all of us doing vaccine trials that we must work hard to ensure that we have a gender balance in the sample size that we recruit for vaccine trials.            

KHOPOTSO: The microbicide, a gel or suppository that can be applied or inserted into the vagina or anus during intercourse, is highly regarded as the answer for those women who cannot negotiate safe sex with their partners. However, there is concern that it only has a 70% efficacy rate in preventing HIV infection.

Dr SINEAD DELANY:

A note of caution would be that I don’€™t think there’€™s a magic bullet. But, I think the more choices we have the more chances we have of dealing with the epidemic.

KHOPOTSO: Dr Sinead Delany, of the Reproductive Health and HIV Research Unit at Wits University. While scientists and researchers are developing interventions to prevent women from HIV infection on the one hand, and governments are pondering whether to increase access to female condoms on the other, women continue getting infected with the virus. HIV was not on the agenda at Beijing ten years ago. But there is no argument that today it poses a threat to women’€™s advancement. As questions are being raised as to what that all-important Beijing congress has achieved for the women of the world, it’€™s important to think: How can we protect women from the socio-economic and political inequalities that make them susceptible to HIV?        

e-mail: Khopotso Bodibe