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Female controlled methods
The most effective method to prevent HIV acquisition and transmission, the condom, is worn by men. Many women do not have relationships of equality with the men they have sex with, and they can experience difficulties 'persuading' men to use condoms. This can be particularly difficult in situations where HIV is not the priority concern (for example, when the woman experiences violence). However, it is also problematic for women in more equal relationships, since many men find condoms unpleasant, and as women are more vulnerable to HIV than men from vaginal intercourse, they may not afford the same priority to condom use.
The female condom is the first product which has been developed to offer women more control over HIV prevention methods. However, it is not a method entirely within women's control. Although, in general, the woman inserts the device, it requires compliance and consent from the man for it to be used. It is extremely visible – many would say unattractive – as it extends beyond the labia. It is possible for the man to avoid it and fuck between the female condom and the vaginal wall, and it is unlikely that the woman would be aware if he was doing this.
Since there are no methods entirely within women's control, and as the vulnerability to HIV from vaginal sex increases for women, the need for new prevention methods is urgent. Microbicides (previously known as virucides) have been spoken about for several years, and are now receiving a fair degree of attention from some policy makers (such as WHO) and sectors of the research community. Currently no proven safe and effective microbicides are available, but research is underway. Microbicides are also beneficial because they offer the potential to protect against sexually transmitted infections, which are a significant contributor to death, illness and infertility around the world.
For more information on the development of microbicides see Microbicides in Developing prevention technologies.