A powerful tool for women
Almost half of the 33 million adults infected (2007) with HIV worldwide are women—up from one-third in 1985. The female condom is the only available method that women and girls can initiate and that provides dual protection. Because of economic, social and gender inequalities, women find it often difficult to negociate safe sex and make their partner use a condom, particularly within marriage. Women who learn to use female condoms can protect themselves even if their partners refuse to use male condoms. In this regard it is an important supplement to the male condom in protecting women and couples from STIs and unintended pregnancy (UNFPA). Strong female condom introduction programmes can pave the way for future protection methods, such as microbicides, when they become available (PATH).
Impact on levels of protected sex
Many studies show that providing female condoms as part of a comprehensive prevention strategy complements the male condom and results in increased levels of protection.
The Female Health Company (FHCO) is the maker of the FC Female Condom (FC1 and FC2), the most important brand for the public sector. Clinical studies in the United States and Japan show that FC1 is 95 percent to 98 percent efficacious in protecting against pregnancy when used correctly and consistently. Studies have shown FC1 to be a highly effective barrier to the viruses and bacteria that cause STIs, including HIV/AIDS. Studies have shown that FC2 and FC1 have similar results.
Protected sex among women in studies in the United States and Brazil doubled after they received female condoms and counseling. Among Madagascar study participants, protected sex rose by 10 percent due to their use of female condoms (PATH).
Availability and challenges with introduction
According to PATH (Global Consultation on the Female Condom, June 2006), female condoms are more expensive than male condoms, yet mathematical modeling has shown that when the female condom is offered as part of a well-planned STI and pregnancy prevention programme, it is cost-effective. For example, one model estimated that use of 4 million female condoms in South Africa, at an estimated unit cost of US$0.77 for product and programme costs, would prevent 1740 HIV infections, with a net savings to the health care system of about $980,000.
Challenges of introducing the female condom include negative perceptions, high costs, limited availabilty, and lack of support for large-scale promotion programmes.
STOP AIDS NOW! partner Oxfam Novib promotes the wide introduction of female condoms. According to Oxfam International, in its report ‘Failing Women, Withholding Protection’, a mere 6 million dollar has been spent on developing a new condom for women in the past ten years. In comparison: in 2006 alone donors spent more than 1 billion dollar on developing new HIV prevention technologies. The lack of investments and innovation maintains the high price of female condoms in comparison with male condoms. An investment of 20 million dollar will make it possible to market a new female condom, encourage competition and bring down prices.
Universal Access of Female Condoms
Oxfam Novib started a new programme, called Universal Access to Female Condoms. Internationally, Oxfam Novib is advocating for the female condom, convincing decision-makers, including UNAIDS and UNFPA, that all women need the choice to prevent HIV and AIDS and unintended pregnancies, so-called dual protection. At country level Oxfam Novib has launched a large-scale female condom programme in Nigeria. The Society for Family Health has taken the lead in the programme and a number of Nigerian counterparts (LAPO, Baobab, GPI, AHIP) are involved in the planning and implementation of the programme.
UNFPA says it is committed to intensify its efforts by scaling up female condom programming to at least 23 countries through the Global Female Condom Initiative. At country level, UNFPA has helped establish condom technical working groups. It also works with key government counterparts and other stakeholders to develop and implement a country-driven female condom strategy. Through UNFPA’s Female Condom programming, access to female condoms increased significantly for the third consecutive year, bringing the total distribution to more than 33 million in 2008.
According to PATH, Four key steps can make female condoms more accessible and available and prevent infections today:
- Develop greater political and social support locally, nationally, and internationally
- Increase public and private investment in female condoms
- Scale up promotion and evaluate impact
- Conduct operations research within the context of increased programming
Technical details
The female condom is a prevention technology that is available to enable couples having safer sex. It is a loose-fitting polyurethane sheath that is 17 centimetres long with a flexible ring at each end. Research suggests that the female condom is as effective as the male condom in preventing pregnancy and sexually transmitted infections (STIs), including HIV. Access to female condoms can increase the proportion of couples having protected sex, offering a lifesaving alternative (PATH).
Click here for an overview of interesting resources on the female condom...
