Melinda Gates writes in Newsweek of possible good news related to women, risk and HIV:

Chanya’s story is not rare. For many women, marriage is a risk factor for AIDS because of their husbands’ dangerous behavior. Worldwide, 80 percent of women newly infected with HIV are practicing monogamy within a marriage or a long-term relationship. This shatters the myth that marriage is a natural refuge from AIDS. And it shows that, more than two decades into the epidemic, our fight against AIDS has failed to address the unique circumstances of women—especially women in the developing world.

Why are women so vulnerable? Physiological differences make women twice as likely as men to contract HIV from an infected partner during sex. In many countries, sexual inequality compounds the hazard by making it difficult, if not impossible, for women to enforce their choices about whom they have sex with, or to insist that men wear condoms. But one of the deadliest problems is that women simply don’t have the tools to protect themselves. Despite the array of breakthroughs we’ve seen for AIDS treatment, prevention efforts still rely on the three practices described by the abbreviation ABC ("Abstain, be faithful, use condoms"). These approaches work, and we must encourage them, but they all depend on a man’s cooperation. For millions of married women, abstinence is unrealistic, being faithful is insufficient and the use of condoms is not under their control.

Through our foundation, my husband, Bill, and I are working to develop tools that can put the power to prevent AIDS into the hands of women. Microbicides are one exciting new prevention tool in development. These are colorless, odorless gels that a woman could apply vaginally—without her partner’s knowledge—to prevent sexual transmission of HIV. Microbicides may also prevent other sexually trans-mitted infections, such as syphilis and gonorrhea, and some act as contracep-tives as well. Microbicides are now being tested by women in several countries with large HIV burdens, including South Africa, Uganda and India. Researchers are also studying other promising measures that could give women the power to protect themselves with-out depending on their partners. For instance, trials in Botswana, Ghana and other countries are studying whether drugs now used to treat HIV may also protect people from being infected in the first place.

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