Tuesday, June 16, 2009

POZ Flashback - Beyond Condoms: Life After Latex

[See how far we've come - or not - in the last 10 years.]

Yet amidst this growing pro-microbicide chorus, one omission goes unnoticed by all but a handful of angry critics who ask,

“What about microbicides for the rectum?”

Published June 1999

Beyond Condoms: Life After Latex

by Michael Scarce, for POZ

Microbicides weren’t our dad’s safe sex. But for us, they’re just a shout away

Countdown Y2K: Part 6 of a 12-Part Series

Imagine a world without condoms. I’m talking not about the cure, a widespread conversion to barebacking or mandatory castration, but a future in which rubbers are obsolete relics, replaced by an inexpensive, easy-to-use, anti-STD gel applied internally to the vagina or the rectum before sex. These “chemical condoms,” known as microbicides, would ideally inactivate a range of harmful bacteria, viruses and other bugs, revolutionizing safer sex as we know it. Contraceptive microbicides such as spermicidal films, foams and jellies have been available over the counter and by prescription for more than two decades. More recently, scientists have begun struggling to develop a similar technology to prevent infection with HIV and other STDs. By 2000, however, the Clinton administration’s $100 million, four- year initiative to develop such “topical agents” will barely even be slouching toward its goal.

As infection rates climb among women, especially in developing countries, the need for a low-cost, female-controlled form of protection has become urgent. Gender inequity within heterosexual relationships has long been a driving force for technology to balance the scales of sexual decision-making, and two organizations have formed in the United States to carry out this advocacy—Microbicides as an Alternative Solution (MAS), in Berkeley, California, and the Alliance for Microbicide Development, in Takoma Park, Maryland. “Because condoms are controlled by the man, both partners must agree to use them,” says MAS’s Bethany Holt, explaining her group’s quest for products that can be used exclusively by the receptive partner. AIDS service organizations worldwide have reported commonplace episodes of domestic violence triggered by disputes over condom use. Even in the absence of intimidation or force, many women have learned to defer their own pleasure and safety in favor of men’s desires. Yet amidst this growing pro-microbicide chorus, one omission goes unnoticed by all but a handful of angry critics who ask, “What about microbicides for the rectum?”

The most astonishing and reprehensible thing is, why, when the gay male community has so much to gain with this scientific development and so much to lose without it, we raise no voice to advocate for it.

Scientists and public health experts have long approached anal sex with a mix of anxiety, scorn and denial. Take, for example, the often-unacknowledged fact that the FDA has never approved a single condom or other device for anal sex. As the scientific agenda of safer sex seems to be guided more by morality than epidemiology, people who practice anal sex have been technologically abandoned.

Read the rest on the IRMA (International Rectal Microbicide Advocates) blog here.


  1. why are there no advocates for rectal microbicide? Because it's a pipe dream. After the abysmal vaginal microbicide trials, which were pulled early because they were so ineffective, the likelihood of developing an effective rectal microbicide is that much further.

    Our research dollars are better spent researching other more promising technologies--such as a vaccine or even PrEP--as well as behavior change and psychological research.

  2. You are wrong anon.

    This article was published 10 years ago and was meant as a historical perspective.

    In fact - much has changed in regard to rectal microbicides, including the development of IRMA - International Rectal Microbicide Advocates - a network of over 800 advocates, scientists, policy makers and funders on 6 continents working on the R&D of a safe, effective, acceptable and accessible rectal microbicde for the women and men who need them. IRMA's website is http://www.rectalmicrobicides.org. Check it out to get caught up on the field.

    There is a full pipeline of products being developed for vaginal use - see http://microbicide.org/cs/pipeline

    And you should know that in 2008 - global investment in microbiicde R&D was about $245 million, an 8 percent increase over 2007 funding levels. About 5 million of that was specifically for rectal microbicides.

    Jim Pickett
    Chair, IRMA


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