Thirty years into the AIDS epidemic, the global community has developed a sense of solidarity and urgency to save lives. On International Women's Day, we need to leverage that solidarity and urgency to help those who are most affected -- women. Currently, half of those infected with HIV globally and 60 percent of those infected in sub-Saharan Africa are women. The same women who are at risk of HIV infection are also at risk of unintended pregnancy. What does the world have to offer women when it comes to prevention of HIV and unintended pregnancy?
Last fall, USAID released for the first time ever guidance on including female condoms in HIV interventions. It highlights the major selling points of the female condom: it is safe and effective, it is a cost effective HIV prevention intervention, it increases protected sex, and it is a largely untapped resource for HIV prevention. It calls for U.S. global HIV programs to build upon PEPFAR's legislative mandate to endorse women-initiated means of protection against HIV/AIDS and promote the female condom as a safe and effective HIV prevention intervention.
Two weeks ago, the World Health Organization issued guidance in response to questions linking increased HIV risk and hormonal contraceptives. It concluded that there isn't enough evidence yet to support that conclusion, but continued to say that the best way to prevent HIV is by doing what we should be doing anyway: providing women access to female and male condoms for HIV prevention and to a wide range of contraceptive options for family planning.
The bottom line is, female condoms are absolutely essential to any and all HIV interventions, as well as to efforts to prevent unintended pregnancy especially among women living with HIV, but they are still grossly underfunded and in short supply. There is quite a demand, and now, the groundwork in the form of guidance and evidence has been laid.
If WHO recommends that all women living with HIV receiving hormonal contraceptives also be counseled about and given female and male condoms -- and USAID recommending that women be "advised" about male and female condoms -- how do these recommendations become meaningful in light of the lack of political will and financial commitment to make male and female condoms available and accessible and ensure uptake and use.
Now is the perfect time for the U.S. to step up funding and policy support for female condoms. The bi-annual International AIDS Conference will be held here in Washington, D.C., in July. A public display of support for female condoms on an international stage signals to the world that 1) female condoms are essential, and 2) the women they protect are valued. The "woman-centered" characteristic is what makes female condoms so necessary. With more than 50 percent of the world's population living with HIV, women are at the center of the HIV pandemic. Providing them with interventions they can initiate themselves, and that they are asking for, makes perfect sense.
On World AIDS Day 2011, the White House recognized the critical role of male and female condoms in any prevention intervention. It seems like political will may be with us now. The building blocks are all there -- we have the evidence, and the demand. All we have to do now is step up.
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