And so I'll bring this up at meetings and
they'll say, you know what it's not either or, we can actually do the pills and
we can do the gender and equality, and the gender and equality interventions.
And what I've come to find though, and
this is I guess my personal evaluation of the situation,
is that the authority accorded to biomedical solutions,
I really do believe undermines structural intervention.
So that when someone with an idea to give pills to the women to prevent HIV comes in
the room and presents that, it sucks all of the air out of the room,
and the social scientists are not left with much leverage to say,
no, no, no, no, no, you know what?
If you take the time to really put all the resources we have into abolishing
the school fees, and helping girls stay in school until they finish secondary school,
and creating situations where women can negotiate condom use,
creating situations where women can enter into the labor force easier,
that you actually get better prevention than you will by
prescribing the pre-exposure prophylaxis.
And so that brings me to my current research projects, which are just
getting off the ground, I'm slowly getting funding trickling in to fund this.
And the idea is to rerun the trial, to give women the pill,
the pre exposure prophylaxis, because I need to compare
structural intervention with the biomedical intervention.
So, one arm of high risk women would have the cocktail,
one woman would have the cocktail and the amount of money that it takes to pay for
the cocktail, which is usually about $50 per month,as
an incentive to take the cocktail, and then the other arm would
just have the $50, which is the cost of that intervention.
And the $50 would be conditional upon remaining HIV-free with the goal,
just saying to them, use this money in any way you want,
but do your best to remain HIV-free, and
we're going to talk about the ways you can do that.
You can either use this to negotiate condom use,
you can use it to ask your partner to get tested,
you can leave your partner, you can share it with your partner, and
yeah, like I said, with the understanding of using more condoms.
You can stay with one partner and maybe there's a sugar daddy that you don't need,
I mean, there's a variety of mechanisms where they could reduce their risk, and
we're not going to tell them which one to do, but we will interview them monthly.
And if at the end of a year or two, there is reduced incidence in that arm, I think
by exploring with the women how they were able to negotiate their structural risk,
we can then focus on those as structural interventions.
And so the goal would not be to say okay, we want to just give women money
around the world so that they can reduce their risk, it would be to
find out how they are negotiating their risk with that empowerment.