title: The promises and limitations of female-initiated methods of HIV/STI protection.
abstract: New methods are now available, and others are being developed, that could enable women to take the initiative in preventing sexually transmitted infections. However, attempts to capitalize on "female-controlled" preventive methods thus far have met with limited success. Female-initiated methods were introduced to intervene in the state of gender relations and assist women who are disempowered vis-à-vis their male partners. Paradoxically, however, we underscore that it is the very structure of regional and local gender relations that shapes the acceptability (or lack of acceptability) of these methods. This paper specifically addresses how the structure of gender relations-for better and for worse-shapes the promises and limitations of widespread use and acceptance of female-initiated methods. We draw on examples from around the world to underscore how the regional specificities of gender (in)equality shape the acceptance, negotiation, and use of these methods. Simultaneously, we demonstrate how the introduction and sustained use of methods are shaped by gender relations and offer possibilities for reinforcing or challenging their current state. Based on our analyses, we offer key policy and programmatic recommendations to increase promotion and effective use of women-initiated HIV/STI protection methods for both women and men.
authors.affiliation: HIV Center for Clinical and Behavioral Studies, NYS Psychiatric Institute and Department of Psychiatry, Columbia University NY, NY, USA. jem57@columbia.edu
authors.forename: Joanne E
authors.initials: JE
authors.lastname: Mantell
authors.forename: Shari L
authors.initials: SL
authors.lastname: Dworkin
authors.forename: Theresa M
authors.initials: TM
authors.lastname: Exner
authors.forename: Susie
authors.initials: S
authors.lastname: Hoffman
authors.forename: Jenni A
authors.initials: JA
authors.lastname: Smit
authors.forename: Ida
authors.initials: I
authors.lastname: Susser
mesh_terms: D001294:Attitude to Health / Q000208:ethnology; D019111:Single-Use Internal Condom; D005260:Female; D014943:Global Health; D015658:HIV Infections / Q000208:ethnology / Q000517:prevention & control*; D006293:Health Promotion / Q000379:methods; D006801:Humans; D007398:Interpersonal Relations; D011209:Power, Psychological; D021841:Safe Sex; D012650:Self Disclosure; D012737:Sex Factors; D012749:Sexually Transmitted Diseases / Q000208:ethnology / Q000517:prevention & control*; D012925:Social Conformity; D040241:Social Marketing; D016387:Women's Health / Q000208:ethnology