Author:Shelley Lees (London School of Hygiene and Tropical Medicine)
Paper short abstract:
Microbicides clinical trials provide an interesting site of observation on how biomedical technologies move from the Global North to the Global South. Research with women participating in a trial reveal how such transfers are understood by Global South women.
Paper long abstract:
The development of a biomedical technology depends prevailing medical and political interests and cultural norms (Lock and Nguyen 2010). Recognition of the need to develop a biomedical HIV prevention tool for women arose from a realisation that women face specific difficulties in protecting themselves from HIV. In the 1990s, Global North feminists called for chemical barriers that would be easy to insert in the vagina, undetectable and "women controlled". Microbicide gels were developed with the potential to be a "feminist technology", having a transformative and empowering effect on women's lives. These technologies were also imbued with ideas about women's sexuality linked to risk and vulnerability.
The process of "transfer" of microbicides from the North to the South depends on tinteraction between society and science, and clinical trials provide such interactions. My research was situated in a microbicide trial and explored sexual discourse that surrounded women participants, within and without the trial. Women's accounts focused on hope about the gel and distrust about condoms, and revealed concurrence with the biomedical frame of the study. They understood the concept of an experiment and understood the purpose of the trial within a discourse of women's empowerment, which for them coincided with their own endeavours to seek autonomy in relationships and HIV prevention. The microbicide gel was found to be ineffective in preventing HIV, however, women's motives to join the trial were about knowledge and thus for them the trial itself was described as empowering, despite the outcome of the trial.
Movement of medical knowledge & practice: crossing borders and constructing boundaries in a global world