Female condom. Image credit: Wikipedia Commons

Today we’d like to announce the publication of Kier Philip’s article on the implications for human rights of the endemic tuberculosis in Chiapas, Mexico. Read it here.

Meanwhile, Catherine Carver, TLS Blogger and medical student at University of Aberdeen, reports on the benefits of the female condom for today’s blog.

The female condom is seen as a way of empowering women because they are responsible for wearing the protection

The World Health Organisation’s report AIDS Epidemic Update 2009 stated in December that “women and girls continue to be affected disproportionately by HIV in sub-Saharan Africa.” (1) The main method of HIV transmission in sub-Saharan Africa is heterosexual sex and approximately 60% of estimated HIV infections there occur in women (1). The United Nations Population Fund (UNFPA) has suggested that the female condom could be one way to tackle this problem because it is the only barrier method available “that women and girls can initiate and in some ways control” (2). They argue that women are often unable to insist their partner use a male condom, and consequently end up having unprotected sex. The female condom is seen as a way of empowering women because they are responsible for wearing the protection

There are other potential benefits to female condoms. For one, the female condom can be put in place hours before sex thereby avoiding any awkward interruptions to intimacy. Second, it does not need to be removed immediately on ejaculation like the male condom does. Third, men who believe male condoms reduce sensation during sex may see the looser female condom as an acceptable alternative. Yet despite having these benefits and an efficacy similar to the male condom, the female condom accounts for just 0.2% of worldwide condom use (3).

One of the main reasons for this is cost. The latest female condom design, the FC2, is 30% cheaper than its predecessor (4) but still cost US$0.35 per unit (5) compared to approximately US$0.03 per unit for male condoms (6). These are public sector prices, and they cost considerably more if bought privately. On a practical note, the female condom can make a rather noisy rustling during sex and some object to its appearance as it hangs several centimetres out of the vagina.

The UNFPA has been trying to change the fortunes of the female condom and one of their success stories is Zimbabwe. Their initiative increased public sector distribution of the female condom from 400, 000 in 2005 to more than 2million in 2008. Sales of female condoms also increased greatly from 900, 000 to more than 3 million (3). They attribute their success to a good marketing strategy, which targeted men as much as women. For instance they emphasised the idea that the male condom is not constricting like the male condom, and promoted the idea that the internal ring can enhance pleasure during sex.

Zimbabwe isn’t the only country where a novel approach to marketing has been used to promote the female condom. In Senegal they come packaged with “bine bine” beads which are an erotic accessory worn around the woman’s hips which make a clicking sound, tackling the noise of the condom. In Sri Lanka, female sex workers market the condom itself as a sex toy and sell clients the idea that allowing them to insert it is a thrill (7).

Some might argue that promoting the female condom is counterproductive because it fulfils the same role as the male condom and costs more. However, while it is true to say that many of its pros and cons overlap with the male condom, there are differences and one the guiding principles in sexual health medicine is promoting choice. In the words of ex-director of the International Planned Parenthood Federation Dr Steven Sinding: “More choice equals more protection. It’s that simple.” (8)

References:

(1) World Health Organization, UNAIDS. AIDS Epidemic Update 2009. Geneva, World Health Organization. Available at: http://data.unaids.org/pub/Report/2009/JC1700_Epi_Update_2009_en.pdf (Accessed 21 February 2010).

(2) UNFPA. The Female Condom: Putting Women in Control. Available from: http://www.unfpa.org/hiv/female.htm (Accessed 21 February 2010).

(3) UNAIDS. Empowering women to protect themselves: Promoting the female condom in Zimbabwe. Available from: http://www.unaids.org/en/KnowledgeCentre/Resources/FeatureStories/archive/2009/20091021_UNFPA.asp (Accessed 21 February 2010).

(4) Medscape. FDA Approves FC2 Female Condom. Available from: http://www.medscape.com/viewarticle/589767 (Accessed 21 February 2010)

(5) FDA Approves Next-Generation Female Condom. Podcast. Available from: http://video.unfpa.org/?v=8842875441113737772009 (Accessed 21 February 2010).

(6) UNAIDS. Basic facts on the female condom. Available from: http://data.unaids.org/GCWA/gcwa_bg_femalecondom_en.pdf (Accessed 21 February 2010).

(7) Burt K. Whatever happened to the Femidom? The Guardian [Online] August 23 2005. Available from: http://www.guardian.co.uk/society/2005/aug/23/health.lifeandhealth (Accessed 21 February 2010).

(8) PATH, UNFPA. Female Condom: A Powerful Tool for Protection. Seattle: UNFPA, PATH; 2006.

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