Health News

Female condoms put HIV prevention in women's hands (Feature)

By Sumita Thapar Aug 7, 2008, 2:47 GMT

Mexico City - The female condom is currently the only woman- controlled preventive method against HIV infection. Yet, it is a poorly funded invention and has been ignored by policy makers, making far too expensive and largely unavailable.

'This is a 15-year scandal born of ignorance and inertia. It has been made doubly worse as the HIV epidemic is now affecting women at a higher rate than men, especially in sub-Saharan Africa,' said Farah Karimi, spokesperson of Oxfam, Britain's leading aid charity.

'We now know that millions of women might have been spared HIV, unwanted pregnancies, and empowered themselves in the process, if they had access to this simple method.'

A new report by Oxfam and the World Population Foundation, 'Failing Women, Witholding Protection,' launched at the XVII International AIDS Conference in Mexico City, said that countries have wasted countless lives by willfully ignoring the best available invention to help protect women from HIV and other sexually transmitted diseases.

'Every day 7,000 young women become HIV positive. We need to do more to support them to protect their health,' said Purnima Mane, deputy executive director of the United Nations Population Fund.

Women account for nearly half of HIV infections worldwide. In sub- Saharan Africa, 75 per cent of those infected are women.

The female condom looks large and unwieldy, but women seem to like it. About 16 centimetres long, it is a polyurethane sheath that covers the vagina, cervix and external genitalia and can be inserted just before intercourse. The only version approved by the US Food and Drug Administration is manufactured by the Female Health Company in London.

Researchers say one of the main problems in making the product widely available to women is its hefty pricetag.

Beyond availability, much training and practice are required before women figure out how to use it. Those who do, say that its advantage over male condoms is that it does not interrupt intercourse and can be inserted well in advance.

In the last 10 years, only 6 million dollars has been spent on developing a new condom for women. In contrast, in 2006 alone, international donors spent more than 1 billion dollars trying to develop new HIV-prevention technologies, Oxfam said.

With little investment and innovation, the price of female condoms has remained unaffordable as compared to male condoms - often 18 times more.

Oxfam said that an investment of 20 million dollars would allow new female condoms to be brought into world markets, increase competition and decrease prices.

In India, the female condom was introduced in 2007 by the National AIDS Control Organization (NACO) and rapidly gained acceptability. In one year, the pilot programme tripled its demand for the condoms - from 500,000 to 1.5 million - while halving the price from 45 rupees (1 dollar) to 23 rupees.

NACO currently socially markets the female condom at 5 rupees (10 cents). India now has 'Female Condom Champions,' who are trained by non-governmental organizations to sell the idea of female-controlled protection and show women how to use it.

Many Indian women say the female condom has been a boon.

In AIDS-hit Guntur district in the southern state of Andhra Pradesh, women claim they can use the female condoms with husbands reluctant to put on the male version, as the former doesn't impact sexual pleasure for either partner.

For all its benefits, governments have been sluggish about supporting female condoms, with the exception of Zimbabwe, where it was introduced in 1997, said Serra Sippel, executive director of US non-profit Centre for Health and Gender Equity.

'In most countries, the female condom is introduced as a pilot for one or two years and withdrawn when funding comes to an end. Investment is critical, as is the 'buy-in' of the national government. They must want to give the product to women,' Sippel said.

In the United States, some government-run centres in New York offer education on and access to the female condom. 'But in Washington you have to go to a sex shop to buy one. In many cases, pharmacists are not even aware of it,' Sippel said.

Lynde Francis of the International Community of Women living with HIV/AIDS, who has been HIV-positive since 1986, said: 'In Zimbabwe, were I work, sexual violence is extremely high. A minister told me the product was not good, 'As women in sex work could infect men if they did not change the female condom for different sexual encounters.''

'When I asked him the difference between 10 men sharing a vagina and 10 men sharing a vagina with a female condom, he said there was none. I said him the difference is that the woman is protected.'

Researchers say there are further, unquantifiable benefits of female condoms as a powerful tool to help women assert their sexual rights.

In Kenya, users say it has enabled the building of better communication between partners about safe sex. In India, women say it helped reduce domestic violence brought on by requests to husbands to use condoms. Women in sex work the world over claim they can now negotiate their own safety.