In-depth: Trials and Tribulations of HIV Prevention Research

UGANDA: Women slow to volunteer for HIV vaccine trials

Photo: Manoocher Deghati/IRIN
Gender imbalances in society make women more vulnerable
Kampala, 12 June 2007 (PlusNews) - Too few Ugandan women are willing to participate in trials of a potential vaccine against the HI virus, local scientists have said.

"We have recorded high numbers of them when we invite them for preparation workshops - at these events we record more women than men - but when you advance to the stage of taking them on as [trial] candidates, they duck off and switch off their phones," said Dr Hannah Kibuuka, of Makerere University and the Walter Reed Project.

The project is a partner in the United States Military HIV Research Programme, which has been jointly conducting two HIV vaccine trials with the university in Uganda since 2002, with the aim of developing a vaccine specific to the HIV sub-type prevalent in Uganda.

Kibuuka told IRIN/PlusNews that the main reason women did not enrol was their lack of autonomy, or dependence on male partners when making major decisions about their lives.

Another deterrent was that "we enrol women of between 18 and 40 years ... the reproductive age bracket, but we have a requirement that one must not conceive - culturally, womanhood is judged according to one's fertility", she said.

Officials at a meeting of women's ministers from 53 Commonwealth countries in the capital, Kampala, said 30 HIV vaccine trials were being held in 24 countries across six continents. Developing countries such as Uganda, where the AIDS pandemic is more serious, have taken an active role in the search for a vaccine.

Gender imbalance in societies often makes women more vulnerable than men to contracting HIV, so more research is needed into a female-oriented prevention strategy that can also empower women.

"Socially women have low ability to negotiate safer sex and this is riding them into their graves. Studies have indicated that women in marriage are more at risk and we see microbicides as the answer that puts women's destiny in their hands," said Dr Florence Mirembe, an HIV researcher at Makerere University and a conference delegate.

Microbicides include a range of products, such as gels, films and sponges, that "have the potential to prevent HIV infection in both women and men by creating a mechanical barrier, though none is yet on the market", she said.

"They are women-controlled and will not need partner consent," she added. "It is easier to use than the female condom which has been difficult to popularise."

The Ugandan Ministry of Health recently announced that it had stopped distributing female condoms due to low uptake.

Mirembe noted that even with microbicide trials, finding large numbers of HIV-negative, willing volunteers was a problem, as was the issue of caring for women who became HIV-positive during the trials.

Global microbicide trials were dealt a major blow earlier this year when researchers halted trials of a gel after preliminary results showed it could increase the risk of HIV infection. Uganda was one of four countries where the cellulose sulphate gel was being tested.

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