Open AccessWHO guidance grounded in a comprehensive approach to sexual and reproductive health and human rights: topical pre‐exposure prophylaxis
Author(s) -
LustiNarasimhan Manjula,
Khosla Rajat,
Baggaley Rachel,
Temmerman Marleen,
McGrory Elizabeth,
Farley Tim
Publication year - 2014
Publication title -
journal of the international aids society
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.724
H-Index - 62
ISSN - 1758-2652
DOI - 10.7448/ias.17.3.19279
Subject(s) - medicine , pre exposure prophylaxis , microbicide , reproductive health , context (archaeology) , microbicides for sexually transmitted diseases , vaginal ring , family medicine , clinical trial , sexual transmission , environmental health , population , human immunodeficiency virus (hiv) , family planning , men who have sex with men , pathology , paleontology , syphilis , research methodology , biology , health services
Two new microbicide products based on topical (vaginal) application of antiretroviral drugs – 1% tenofovir gel and the dapivirine ring – are currently in late‐stage clinical testing, and results on their safety and effectiveness are expected to become available in early 2015. WHO guidelines on the use of topical pre‐exposure prophylaxis (topical PrEP) are important in order to ensure that these new prevention products are optimally used. Discussion Given that these new topical PrEP products are designed to be woman initiated and will likely be delivered in reproductive health settings, it is important to ensure that the guidance be framed in the context of comprehensive sexual and reproductive health and human rights. In addition to the safety and effectiveness data resulting from clinical trials, and the regulatory approval required for new products, the WHO normative guidelines on the use of topical PrEP will be essential for rapid roll‐out in countries. Conclusions Human rights standards and principles provide a framework for the provision of woman‐initiated HIV prevention products. These include addressing issues related to the gender inequities which are linked to the provision of HIV‐prevention, treatment and care for young girls and women. Effective programming for women and girls must therefore be based on understanding the local, social and community contexts of the AIDS epidemic in the country, and adapting HIV strategies and programmes accordingly. Such a framework therefore is needed not only to ensure optimal uptake of these new products by women and girls but also to address sociocultural barriers to women's and girls’ access to these products.