A new vaginal gel was announced at the international Aids conference in Vienna last month. The gel contains 1% of an antiretroviral drug called tenofovir, which a recent study said could cut down the spread of HIV infection in women by 39%. This scientific development is important, and I don't want to undermine the technical achievement – it is going to save a serious number of lives. But it represents an opportunity for HIV-ravaged countries to wash their hands of how men deal with sex. The standing ovation at the Aids conference leaves behind a fear that we're about to abandon the work on changing attitudes towards sex, and in turn how women experience sex as well.
The goal of the gel was to accommodate women who are unable to negotiate condom use. According to a study by UNAids, most of the world's women are in this position. South African health minister Aaron Motsoaledi said he would flag the gel's clearance into clinics to be fast-tracked, an approach erring on the side of damage control: the image is of a woman down on the floor being kicked and now we have given her some armour, with a subtle acknowledgment that we are all powerless to stop the kicking.
There are legitimate reasons as to why Aids claims the lives of 1000 people a day in countries such as South Africa: an economic gap between the genders, shame of infection, inconsistencies in public policy and lack of healthcare infrastructure. Yet the excitement around the gel's existence is a tacit endorsement that male enjoyment of sex is beyond reproach, and that he can not be taught how to practice safer sex. Isn't the joy around this medical triumph partly fuelled by a relief that we won't have to wrestle with this guy's social challenges any more?
It was even mentioned in the study, quite proudly, that the men claimed to not be able to feel any pleasure difference during sex when using the gel. South Africa has a government health department implying that huge funds and research should go into making allowances. It's as if science is ready to bow to these proclivities, rather than continue to dismantle them. It could be argued that it's too late for social pleasantries. Cynically: they have been given education and funding to practice safe sex and they failed.
If the success rate of the gel doesn't go above 39% then it isn't going to replace the condom (which is 98% effective with perfect use, and 85% effective with typical use), but simply help a coupling that had no protection initially. The gel is going to be popular in the direst of circumstances, and for this reason it's not going to take off in developed countries. People that are taking precautions with more consensual sexual habits are going to want a higher effectiveness percentage.
The gel might be seen as a quick-fix where it is sexual education that is needed the most. While the percentage stays low, there may be a continuing plea to assist the men who are impoverished and uneducated, but if it becomes more effective (which would be brilliant to lower infection) then the armour will be sufficient, leaving women to bear the brunt of their sexual safety.
