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Woman cutting produce in a bowl on her lap, with her daughter standing next to her.

Itayi, a Zimbabwean mother, is one of six clinical trial volunteers featured in a Global Campaign for Microbicides photo exhibit. Photo: Martha Rial.

Global Campaign for Microbicides advanced HIV prevention options and women's role in research

Itayi sees the funerals each weekend. Her neighbors are dying from HIV, but the 35-year-old mother dreams of a different future for her three daughters. “Women all over the world are fighting against HIV, fighting to protect themselves,” she says. “My hope is for my daughters not to have HIV.”

Itayi, who does not have the virus, is among the thousands of women who have volunteered for clinical trials to study new types of HIV prevention tools. Called microbicides, the tools have the potential to offer protection from HIV and possibly other sexually transmitted infections.

The Global Campaign for Microbicides, housed at PATH from 2001 until its closure in 2012, led an unprecedented effort to build international support for these new, woman-initiated tools for HIV prevention. Along the way, the campaign fought to give women like Itayi a prominent place in discussions about how to prevent HIV, fostering new conversations and understanding among scientists, advocates, and the people involved in clinical trials of microbicides.

Tools that women can use

Worldwide, nearly half of all new HIV infections occur among women. Women are biologically more vulnerable to HIV infection during heterosexual sex than men, and they often have less power to protect themselves against infection. Microbicides, such as vaginal gels or a daily pill called pre-exposure prophylaxis, could offer women new options for protection.

In 1998, members of the women’s health movement and the HIV community launched the Global Campaign for Microbicides to focus world attention on the critical need for new HIV prevention options, especially for women. With limited funding and an ambitious vision, campaign staff handed out flyers at international AIDS conferences, supplied grassroots advocates with action kits and training to raise awareness and generate demand for new products, and developed a network that eventually grew to more than 300 partner groups worldwide. In Africa, Asia, Europe, and North America, they mobilized funding and support for research into microbicides to further their development.

As microbicides moved into larger-scale trials, the campaign expanded its work in Africa to engage clinical trial researchers and communities in effective microbicides research. The campaign’s staff authored policy briefs for national decision-makers, conducted media outreach to families and communities, and created an online course to help clinical trial staff and advocates explain the science and trials to others.

When trials found several microbicide candidates to be ineffective, campaign staff advised patience and reminded all those involved in the field that every outcome—even if the product didn’t work—builds information for future trials.

Groundbreaking results

In 2010, thanks to the participation of women across Africa, a landmark announcement jolted new energy into microbicide research. Results from the CAPRISA 004 clinical trial in South Africa showed that a vaginal gel called tenofovir provided women with moderate protection from sexually transmitted HIV.

The trial results proved to be a milestone for the HIV prevention field, and for women and advocates who had long sought a new tool in the fight against AIDS. Building on its decade of experience in working with all parts of the field, the Global Campaign for Microbicides helped explain what this milestone meant for women. For the first time, CAPRISA 004 showed that a microbicide can help prevent HIV, and the study results set the stage for ongoing efforts to develop an effective product.

Making gains for prevention

As the microbicides field grew, the campaign continued to represent women’s interests and used a variety of approaches to draw attention to the need for new prevention options. Through media outreach, policy briefs, an online learning course, newsletters, and other materials, the campaign kept advocates and decision-makers informed and successfully built support for the development of new HIV prevention products. In Kenya and South Africa, the campaign influenced the countries’ decisions to include women and microbicides in their national AIDS strategic plans.

In 2011, the campaign launched a photo exhibition depicting the lives of Itayi and five other women who have participated in microbicides trials. The powerful images in “A Day in the Life” present a unique view of the real people who have contributed to advancing microbicides research and who have a deep interest in seeing microbicides become a tool that they or their children can use. These images have introduced policymakers and researchers to the women at the heart of their work.

Today, as more women’s stories are heard, researchers are closer than ever to developing an effective microbicide. Several candidate microbicides are in various stages of clinical study, and the campaign’s work has helped researchers and advocates better understand women’s needs and desires to avoid HIV infection. Numerous groups are carrying forward the work of the campaign, and advocates continue to fight for options that will put the power of HIV prevention into women’s hands.

Resources

Over more than a decade, the Global Campaign for Microbicides produced a wide variety of materials to support the development of women-initiated tools for prevention of HIV infections. Several are available in PATH’s publications catalog; highlighted resources are below.

In Women's Hands video on YouTube
PATH, 2004
First launched on World AIDS Day in 2004, this 11-minute film captures what it means to be women in a world of AIDS—a world where many women have little say about relationships. About sex. About condoms. And few ways to protect themselves against HIV. The film introduces its audience to a handful of scientists and advocates who are racing to curb the loss of future generations from this epidemic through the development of microbicides.

Mapping the Standards of Care at Microbicide Clinical Trial Sites
Global Campaign for Microbicides, 2008
In 2006, the Global Campaign for Microbicides began to map the standards of care and prevention provided to participants in late-stage microbicide trials. The resulting report provides an independent assessment of the health care and prevention services provided to women in the trials. It explores the factors that inform care-related decisions at trial sites, and it offers recommendations to strengthen the HIV prevention research field’s ability to respond to care-related challenges in the future.

Standards of Prevention in HIV Prevention Trials
Global Campaign for Microbicides and PATH, 2010
This report covers a 2009 consultation in Kampala, Uganda, that was convened by the Global Campaign for Microbicides, the Joint UN Programme on HIV/AIDS, and the US Centers for Disease Control and Prevention. It includes recommendations related to key ethical and practical questions on the design and implementation of clinical trials.