Celebrating The First Ever Global Female Condom Day

Shobha Shukla *

For the first time ever, people from all over the world will observe Global Female Condom Day on Wednesday, 12th September 2012. The Chicago Female Condom Campaign will help lead the way calling for greater access to, and increased education on the importance of female condoms. The purpose of this dedicated day of action is to demonstrate the need for this important, yet greatly underutilized, safe sex tool. Advocates and organizations across 21 countries aim to promote female condoms through community education, distribute female condoms and call for greater access at clinics, businesses and pharmacies.

A female condom is a safe device that is used during sexual intercourse as a barrier contraceptive and enables women to reduce their risk of sexually transmitted infections (such as gonorrhea, syphilis, and HIV) and unintended pregnancy. Invented in the 1980s by a Danish physician Dr Lasse Hessel, it is worn internally by the female partner and provides a physical barrier to prevent exposure to semen or other body fluids. It could be a misnomer in the sense that it offers receptive partners of any gender the ability to reduce HIV and STI transmissions, thus enabling people of all genders who engage in vaginal and/or anal sex greater ability to protect their health and the health of their partners while enabling women to take greater control of their own sexual health.

“Female condoms are the only barrier method that can be initiated by the receptive partner, which allows women and men take control of their own health,” said Carole Brite, President and CEO of Planned Parenthood of Illinois. “It is imperative that women and men are aware of all the options available to them so they can choose the method that is best for them in order to stay healthy and safe.”

The first female condom FC1 introduced in 1988 was made of polyurethane. A newer model made of nitrile rubber, the FC2, was introduced in 2005. Both models have flexible rings at each end. The user pinches the inner ring together to slide the condom deep into her vagina. When released, the ring opens and holds the condom in place inside the vagina. For anal protection, the user may pull out the inner ring, add lubrication inside the condom, and then insert it into the receptive partner’s rectum.

MORE YOUNG GIRLS ARE BECOMING HIV POSITIVE

Female condoms usage assumes greater relevance today when we are aiming to tame the HIV virus by using combination prevention therapies. With over 34 million people living with HIV and with infection rates among young women (15-24 years) being twice as high as among men of the same age globally, prevention and protection packages in general, and specifically for women will help them and give them more choices.

In an interview with CNS at the ongoing AIDS Vaccine 2012 conference, Dr Mitchell Warren, Executive Director of AVAC (a global HIV prevention advocacy organization) conceded that, “The HIV epidemic is increasingly having a female face—not just women but young women, and data from South Africa confirms that more and more young girls are falling prey to HIV. When we talk about female initiated or female controlled prevention methods, it can take many forms. I think the female condom is already a great female initiated method and can be a great blessing for some women.”

Yet, even after nearly 20 years of its existence (US FDA approved it in 1993), this woman friendly tool finds very few takers. According to the United States Agency for International Development (USAID), currently female condoms comprise only 1.6% of total condoms distribution globally. Thus only a very small fraction of the women worldwide that could benefit from access to female condoms are able to access them.

What could be the reason? Perhaps its high cost, coupled with apathetic attitude on part of governments and the bias of healthcare providers against the unfamiliar device pushes it to the back shelf. Studies done in more than 40 countries have shown that once people become familiar with the female condom, it is viewed as acceptable by people from a wide range of socio economic backgrounds and ages. Most user concerns about the female condom can be resolved by positively introducing the product to both providers and potential users; making it affordable; and encouraging women to become comfortable with using it. Donors and governments need to be more aggressive in funding purchases and assuring good uptake of the product.

It becomes all the more significant to make female condoms popular in countries like India where women have little control over their own sexual reproductive health, and are more often than not dependent upon their male partners to follow safe sex practices. It is strange that though there is always a big talk about empowering women and young girls (even if it be for population control and/or protection from HIV and other sexually transmitted diseases) there is no aggressive promotional campaign to popularise the female condom.

Most Indian women, even in urban areas, are not aware of its existence, let alone access it. Hindustan Latex Lifecare Limited (HLL), which launched the female condom in India in 2006, produced 320,000 female condoms in the last fiscal year 2011-2012, of which only 38,000 pieces were sold in the open market and a major bulk of 280,000 pieces was procured by the National AIDS Control Organization, chiefly to be distributed amongst sex workers under its AIDS Control Programme.

The market price of the female condom is prohibitively high at Rs.100 for a pack of three in contrast to the male condom priced at less than Re 1 per piece manufactured by the same company. It is high time that the female condoms are brought out from the closet, made available at affordable prices to women in general, and not merely targeted high risk populations in government programmes.

“For anyone who engages in vaginal or anal sex, there is an immediate need for more access to female condoms. We can only create an AIDS-free generation when women, men, transgender people, and youth can protect themselves. We need a multitude of HIV-prevention tools to meet people’s needs and desires. More women and men need to know about female condoms, and be able to access and use these lifesaving tools,” said Jessica Terlikowski, Director of regional organizing for the AIDS Foundation of Chicago (AFC).

While we women wait for the vaginal microbicide gel and the dapivirine ring which in the process of getting validated by field studies, let us at least demand greater access to and increased education on the importance of female condoms as a potent tool in our armoury to protect and prevent us from acquiring the deadly sexually transmitted viruses. Governments around the world will have to increase awareness, access, and use of female condoms through collaboration, training and advocacy.