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Studies have shown that, when used correctly and consistently, the female condom is a reliable protective tool against most Sexually Transmitted Infections (STIs), including HIV/AIDS and unintended pregnancies. Popularly referred to as Umkhumbi, the female condom when first introduced in the country early 2000, came with mixed feelings from traditionalists.
Swaziland has the highest HIV infection rate and women are the most infected with a prevalence of around 49 per cent among women attending antenatal care and introduction of the female condom is a relief. The infection rate is a clear indication that women are the most vulnerable group so it is not enough to rely on the man to use a condom.
There are so many factors that contribute to this vulnerability, including cultural ones. However, the female condom although ridiculed by staunch traditionalists, who sometimes refer to it as Umkhumbi is slowly becoming popular in Swaziland as more women are now using it and some men feeling more comfortable with it. The introduction of the female condom came as a relief to many women because it gives them control instead of depending on their partners for protection.
PSI Swaziland, an organisation that focuses on providing low cost, high quality HIV/AIDS prevention products and developing innovative HIV/AIDS prevention communications campaigns, introduced the Care female condom brand into the country. The condom has been a new option for HIV/STD prevention and contraception.
Many studies have recommended the use of female condoms as the primary mode of protection against STIs.
Suggestions that have been presented to decrease HIV/AIDS among women include promoting abstinence and the use of the male condom. Little recognition and support have been given for prom-oting the female condom as a viable solution to combating the epidemic.
The female condom efficacy rate, with perfect use, is 97 per cent protection against STIs, including HIV/AIDS. Female condoms are conveniently available over the counter. In addition, it can be inserted before coitus to protect women against pre-ejaculate seminal fluid.
Most interesting is that female condoms are a very effective method of decreasing transmission of HIV/AIDS and other STIs. In fact, female condoms have a number of advantages over the male condom:
Advantages of the female condom
l It gives women an opportunity to share responsibility of using protection with their partners. It also provides an alternative if the partner is unwilling to use a male condom due to personal, cultural, religious or other reasons.
l Using a female condom does not depend on male erection and can thus be placed inside the vagina prior to sexual intercourse. As it can be inserted up to eight hours before intercourse, the interruption of sexual spontaneity can easily be avoided.
l Due to the nature of the material which is used for making female condoms (polyurethane or nitrile) both the water-based and oil- based lubricants can be used.
l The characteristics of the material also make it strong, durable and usable for people who are allergic to latex.
l Additionally, female condoms are just as discrete and easy to carry as a feminine napkin or personal wipes.
l Another major advantage of the female condom is that it also encourages women to have choice, responsibility and accountability for their own protection against HIV/AIDS and other STIs.
l Women do not have to rely solely on male condom negotiation skills or depend on their partners to use a condom.
l It gives women the right to choose the form of protection they are comfortable using. According to the World Health Organisation, "The female condom has been shown to contribute to women’s sense of empowerment, especially if supported by education and informational activities."
l Women now have a negotiation tool that can be used in ways that may not be as threatening to their partners. If the male decides he does not want to use a male condom, the female has an alternative form of protection.
It is important to point out that women still must negotiate the use of the female condom with their male sexual partners. A new study showed that female condom users use negotiation skills (such as direct, semi-direct, indirect or nonverbal communication) and additional discourse strategies (such as describing the female condom as a sexual toy) when negotiating female condom use.
Women who use communication styles that engage their male partners may end up using the female condom more frequently than other women. These communication skills can be taught in conjunction with training sessions on how to use the female condom.
Disadvantages of the female condom
l One disadvantage of the female condom is that they are more expensive than male condoms.
l Also, they are not as widely available in drugstores and clinics as latex male condoms.
l Subsidisation of the female condom through international partnerships has been shown to vastly improve access to the method in other countries.
l Many people may dismiss the female condom as a viable protection option due to its appearance, size and awkward shape.
l It may take more than one attempt at inserting the device before a woman feels confident in using it. Problems, such as slippage, breakage and semen exposure, decline with use, suggesting that the more a woman uses the female condom the less likely she is to experience mechanical difficulties. New users are more likely to have mechanical problems, thus the efficacy rate is lower for these women and other women who experience continued mechanical problems. An explanation and instructions for using the female condom are needed, as with any contraceptive device. Use of a pelvic model is also recommended to optimise the demonstration of the proper technique.
Recommendation
The marketing strategy of female condoms should be updated in such a way that it is viewed by women as an empowering, fashionable and lifesaving method that can be used to widen their protection options.
Female condoms should be distributed to the public in the same ways that male condoms are distributed throughout the country. Once effective social marketing techniques are implemented, support from the public health community is shown, and proper education of the use of the female condom is taught to women, female condoms will become a respected and viable method of protection against HIV/AIDS and other STIs.
It is important that healthcare providers offer the female condom as an option for protection from STDs and pregnancy to all clients, regardless of gender. |
