August 2014 — FHI 360 designed this tool to help managers in public health facilities evaluate the extent to which a facility has the material, technical and human resources necessary to provide microbicides. This tool is a product of a mixed-methods study implemented under the Preventive Technologies Agreement (PTA) from March 2013 to August 2014. During the study, researchers examined the implementation of Kenya’s Minimum Package for Reproductive Health — HIV Integrated Services in public-sector health centers. The minimum package consists of recommendations for different types of integrated services in Kenya, developed with the goal of operationalizing the country’s National Reproductive Health — HIV Integration Strategy.
Manual for Conducting a Gender Analysis for Microbicide Introduction
August 2014 — Microbicides have been hailed as a much-needed female-initiated HIV prevention method. But even if an effective product is identified and licensed for introduction, many women will still face gender-related barriers to accessing and using microbicides. This manual provides guidance for conducting a gender analysis in a country preparing to introduce microbicides. A gender analysis can strengthen the effectiveness of health and development programming by identifying gender inequalities that may affect program outcomes and potential ways to address those inequalities. We outline the steps to conducting a gender analysis for microbicide introduction, share lessons learned from pilot testing in Kenya and South Africa, and provide tools and resources for conducting a gender analysis for microbicide introduction.
Engaging Male Partners in Women’s Microbicide Use: Evidence and Recommendations
August 2014 — Vaginal microbicides are considered a groundbreaking HIV prevention tool because women can use them without a male partner’s knowledge or consent. Male partners, however, have played an important role in product acceptability and adherence in clinical trials. Thus, a fundamental question to address is, “How can we balance the promotion of a method that does not require men’s involvement with the reality that men often play an important role in their partners’ effective use of this woman-centered technology?” This document synthesizes the evidence on men’s roles in women’s use of microbicides in clinical trials and makes recommendations for engaging male partners in future microbicides research and product introduction.
Gender Analysis for Microbicide Introduction: Process, Recommendations and Advocacy (Slides for Adaptation and Use)
June 2014 — FHI 360 conducted a gender analysis in Kenya and partnered with Sonke Gender Justice to conduct a gender analysis in South Africa to identify potential gender-related constraints and opportunities to women’s microbicide use. This PowerPoint presentation describes the gender analysis for the microbicide introduction process, key findings and recommendations for future product introduction, and steps that can be taken now to prepare communities and health systems for a gender-transformative microbicide introduction. The slides are intended to be adapted by anyone who wishes to include a gender perspective in a presentation on microbicides. We request that the content be cited to FHI 360 and Sonke Gender Justice.
To obtain the presentation for adaption, please email Rose Wilcher at rwilcher@fhi360.org.
Findings from a Gender Analysis for Microbicide Introduction in South Africa
April 2014 — FHI 360 and Sonke Gender Justice conducted a gender analysis for microbicide introduction in South Africa. The process included a desk review, interviews with key stakeholders and an interpretation meeting to identify gender norms and inequalities that increase women’s HIV risk and could inhibit women’s access and adherence to microbicides in the future. This brief outlines 11 strategies that could be part of a microbicides introduction program to overcome these gender-related barriers.
HIV Prevention for Women in Kenya: An Advocacy Guide for Gender-Sensitive Microbicide Introduction
April 2014 — These advocacy tools, based on findings from a gender analysis in Kenya, can be used to raise awareness of key gender issues that need to be addressed in planning for microbicide introduction in Kenya. They include: (1) a summary of gender issues that will affect women’s microbicide access and use; (2) guidance for policymakers and program designers on developing a gender-transformative microbicide introduction program; and (3) three case studies that nongovernmental organizations and other advocates in the community can use to provoke discussion about microbicides.
A Pocket Guide to Thinking About Gender & Vaginal Microbicides in South Africa
April 2014 — FHI 360 and Sonke Gender Justice conducted a gender analysis in South Africa to identify gender-related barriers and opportunities to women’s microbicide access and use and to make recommendations for addressing those barriers. This pocket card, created with input from the South African National AIDS Council (SANAC) Men’s and Women’s Sectors, is designed to build support for a gender-integrated microbicides rollout among both community members and policy makers.
A New Product for Women: Microbicide Gel (brochure) (English, Swahili)
2014 — The Communicating about Microbicides with Women in Mind project developed and assessed the effectiveness of a trifold brochure for potential future microbicide gel introduction in Kenya. It describes microbicide gel, its effectiveness, who can use it, how to obtain it and how to insert it. This brochure could be distributed by health care providers during counseling sessions and by HIV prevention programs in the community. The brochure was written in both English and Swahili.
Advocacy Brief: Gender Considerations for Microbicide Introduction
December 2013 — Recommendations for reducing gender-related barriers to microbicide access and use, based on analyses in Kenya and South Africa, are summarized in this brief. PTA staff members conducted the gender analyses — one in Kenya and another with Sonke Gender Justice in South Africa — to inform future introduction of microbicides. Noting that many of the findings and recommendations apply to current HIV-prevention efforts, the brief lists actions that advocates can take now to address gender-related barriers to HIV prevention and begin preparing for microbicide introduction.
Effectiveness and Safety of Tenofovir Gel, an Antiretroviral Microbicide, for the Prevention of HIV Infection in Women
July 2010 — The results of the Centre for the AIDS Program of Research in South Africa (CAPRISA) 004 trial of the use of tenofovir gel before and after sex to prevent HIV infection among women in South Africa are presented in an article in the journal Science. CAPRISA 004 assessed the effectiveness and safety of a 1% vaginal gel formulation of tenofovir, a nucleotide reverse transcriptase inhibitor, for the prevention of HIV acquisition in women. A double-blind, randomized controlled trial was conducted comparing tenofovir gel (n = 445 women) with placebo gel (n = 444 women) in sexually active, HIV-uninfected 18- to 40-year-old women in urban and rural KwaZulu-Natal, South Africa. HIV serostatus, safety, sexual behavior, and gel and condom use were assessed at monthly follow-up visits for 30 months. HIV incidence in the tenofovir gel arm was 5.6 per 100 women-years (person time of study observation) (38 out of 680.6 women-years) compared with 9.1 per 100 women-years (60 out of 660.7 women-years) in the placebo gel arm (incidence rate ratio = 0.61; P = 0.017). In high adherers (gel adherence > 80%), HIV incidence was 54% lower (P = 0.025) in the tenofovir gel arm. In intermediate adherers (gel adherence 50 to 80%) and low adherers (gel adherence < 50%), the HIV incidence reduction was 38 and 28%, respectively. Tenofovir gel reduced HIV acquisition by an estimated 39% overall, and by 54% in women with high gel adherence. No increase in the overall adverse event rates was observed. There were no changes in viral load and no tenofovir resistance in HIV seroconverters. Tenofovir gel could potentially fill an important HIV prevention gap, especially for women unable to successfully negotiate mutual monogamy or condom use.
Read full article: http://www.sciencemag.org/content/329/5996/1168.long
