By Alexa Mieses
Picture taken from Nature.com
The New York Times reported today that a vaginal microbicidal gel has given women in one study a 39% chance of protection from the HIV virus. The microbicide contains a nucleotide reverse transcriptase inhibitor, which prevents the virus from reproducing. The study involved a double-blind, randomized controlled trial which compared tenofovir gel (the microbicide) with placebo gel in sexually active, HIV-uninfected 18- to 40-year-old women in urban and rural parts of South Africa. The study involved 30 months of follow-up with each of the women to assess their HIV serostatus, safety, sexual behavior, and gel and condom use. Read the original journal article here.
If such a microbicide is approved, to what extent will African women have access to the vaginal gel? One issue is cost. As the New York Times article mentions, each dose of gel is cheap, however, the patented applicators are rather expensive (forty cents each). Also, men have the authority in most African sexual relationships. While the microbicide may allow an African woman to decrease her chances of contracting HIV without the man's knowledge, will the fact that many physicians are male create a barrier to access of the gel? As of 2006, 70% of all physicians registered with the Health Professions Council of South Africa were male. Will a male dominated world serve as a barrier for African women to obtain the gel? I ask this question because in other countries like Chile and the United States, religious beliefs or political agendas, not whether one is male or female, has created barriers to certain reproductive rights.
The recent history of the emergency contraceptive pill in Chile is more of a flip-flop story of conflicting ideals. In 2006, first female and former Chilean president, Michelle Bachelet, began to more firmly advocate for women's contraceptive rights. By 2007, a presidential mandate made authorities ensure that public health centers made emergency contraception, or the morning-after pill, available. By 2008, courts ruled to only make the pill available in pharmacies and required a prescription. Read more here. Pharmacists would often refuse to sell the pill to women, even with a prescription, sometimes claiming the pill was "out of stock." In reality, religious beliefs instilled in many of the country's people (and pharmacists), often served as the basis for such behavior. Nearly 100 pharmacies were found failing to stock the pill altogether. In early 2010, at the end of her presidency, Bachelet once more was able to sign legislation that allowed the pill to be distributed freely throughout Chile. However, women in Santiago still report a stigma surrounding the purchase of the morning-after pill.
Africa and South America are not the only continents in which access to certain reproductive rights has been an issue. Abortion, while it is a very sensitive subject to some, has been the center of American media and political debate for some time. Since the Supreme Court ruling of Roe v. Wade in 1973, abortion has been legal. However, despite the fact that it is not illegal in many states, there are many barriers that sometimes make it impossible to have an abortion. While most restrictions regarding length of gestation are put in place for good reason, many states create certain restrictions which make it difficult for a woman to undergo an abortion. Also, women with little money or no health insurance often cannot pay for abortions. Additionally, in some places there is limited availability for medical training on abortion. The Association of Reproductive Health Professionals reported that although the Accreditation Council on Graduate Medical Education now requires that training in abortion be made available to all Ob/Gyn residents, as of 2008 only half of Ob/Gyn residency programs offer routine training in abortion care. Finally, violence and harassment of women seeking abortion and/or health care professionals that perform abortions, has created a barrier to the procedure.
As technology develops and new procedures and drugs are created, the political milieu of countries across the globe and women's rights also evolve. Regardless of the moral foundation upon which you stand, it is important to always remain well-informed of scientific developments to better take care of your health.
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