Female and Male Condoms: Whose Responsibility?


Last week I attended an NGO
session at the UN Commission on the Status of Women called "Female and
Male Condoms: Men and Women Sharing Responsibility for Prevention,"
organized by the Center
for Health and Gender Equity

(CHANGE) and co-sponsored by the United
Nations Population Fund

(UNFPA), the AIDS
Vaccine Advocacy Coalition

(AVAC) and several other non-governmental organizations and UN agencies. 
While underscoring the need for effective programming and advocacy around
female and male condoms, the session aimed to debunk the misconception
that male condoms should be used and initiated by men and female condoms
should be used and initiated by women. 

"I would love to go back
in time and change the name of the ‘female condom,’" said Mitchell
Warren, executive director of the AIDS
Vaccine Advocacy Coalition
,
who spoke at the session.  It’s not that he was discounting the
importance of female condoms for women’s reproductive health and empowerment. 
After all, female condoms are still the only
available HIV and pregnancy prevention method designed for women’s
initiation, and they can help put the power of prevention in women’s
hands.  Rather, "female" condom is a misnomer, since it obscures
the fact that men can and do initiate female condom negotiation, and
often participate in their insertion and use. 

According to panelist Edinah
Masiyiwa, executive director of the Women’s
Action Group
(WAG)
of Zimbabwe, many men in WAG’s male and female condom trainings prefer
to lead insertion of the female condom when having intercourse with
their female partners.  And the exciting thing about men getting
involved in female condom use is that it can help improve and increase
communication between partners, contribute toward joint responsibility
for HIV prevention and even lead to increased pleasure and satisfaction. 

The same concept holds true
for male condoms, which tend to be implicitly associated with men. 
But we know that many women play a major role in male condom use and
initiation-from suggesting that men use a condom to actually putting
it on their partner.  I think it’s safe to say that this "dichotomy"
between men / women and female condoms / male condoms is false, and
both women and men have roles and responsibilities when it comes to
negotiating and using female and male condoms. 

But how do we get to a place
where partner negotiation and communication around condom use are fluid
and non-threatening, where women and men assume equal responsibility
for initiating HIV prevention? 

As Mitchell stated, "products
don’t protect people, people do."  Male and female condoms
that sit in warehouses or on store counters aren’t protecting people. 
Even condoms that aren’t used correctly aren’t fully protecting
people!  Women and men who use condoms correctly and consistently
protect themselves and each other, but they can’t do it alone. 
Women and men – and youth – must have access to female and male condoms
and to education and skills-building programs, particularly in cultures
and locations where condoms are stigmatized.   

Comprehensive sex education
is one critical avenue for cultivating these skills, but it must be
truly "comprehensive."  Maxwell Ciardullo of the Sexuality Information
and Education Council of the United States

(SIECUS) stressed this during his presentation on the importance of
thorough discussions about condom use within sex education programs
in the U.S.  "We have to make sure we don’t allow ‘comprehensive’
sex ed programs to be abstinence plus a condom demonstration," he
said.   

In fact, Maxwell argued we
need to go way beyond a stand-alone condom lesson and take social, environmental
and personal factors into account.  Truly comprehensive programs
should address gender roles and expectations (does a "real" man
carry a condom?  Does a "good" girl carry one?), men and women’s
familiarity and comfort with their sexual anatomy, trust issues, gender-based
violence, sexual orientation (what about condom use for men who have
sex with men and lesbians who may have occasional male partners?), risk
perception and homophobia.   

Edinah echoed Max about the
need for comprehensive sex education and raised additional considerations,
such as cultural sensitivities and the role of pleasure.  For example,
WAG’s trainings in Zimbabwe address cultural issues affecting women’s
agency and their reproductive health, such as violence, wife inheritance
and polygamy.  WAG’s programs on sexual and reproductive health
are holistic, nonjudgmental, and empower participants regardless of
their HIV status, gender or other social location.   

WAG’s programs do not shy
away from talking about male and female condoms in a "sexy" way. 
WAG actively promotes women and men’s right to pleasurable sex, teaching
that condoms can be a tool for pleasure.  For instance, Edinah
reported that many men love the "tickle" they feel from the inner
ring of the female condom, and many women love the "tickle" they
get from the outer ring.   

So where do we go from here? 
"It takes a village to achieve comprehensive responsibility for prevention,"
as Mitchell aptly stated.  Even when women and men have the information
and skills to use female and male condoms effectively, we still need
to ensure that policies and programs are in place to support successful
procurement, distribution and training, in addition to adequate financial
investment. 

One way people can help make
comprehensive male and female condom programming a reality is to join
the Center for Health and Gender Equity’s Prevention Now! Campaign
at www.preventionnow.net.  The Prevention Now! Campaign
is a global campaign to dramatically increase donor and government funding
for the purchase, distribution and program support needed to expand
access to female and male condoms and other existing prevention options
for women and men, and the campaign is always looking for new advocates.    

HIV/AIDS, women’s rights,
and sexual and reproductive health and rights advocates must demand
access to male and female condom supplies and programming today. 
Together we can bring about policy and program change at the local,
national and global levels-so make your voices heard! 

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  • http://www.condomologist.com invalid-0

    Thank you Kimberly for bringing this issue to light. As condoms are the only means to protect against pregnancy and STDs when having sex, it’s vital that we explore new avenues in addressing their use (or lack thereof) in a more sex-positive, truly comprehensive way. I’d add just a few things to the discussion. One way to eliminate the male-female issue is to refer to condoms as insertive and receptive (while I like to call the female condom “receptive” and the male condom “insertive,” some folks could miscontrue this nomenclature since one inserts a female condom…) But more importantly, the female condom can be used anally by men, and by calling it female, it reduces the likelihood that this will become more common practice. Also, I think it highly necessary to make clear during sex ed programming and general condom-promotion campaigns the wide variety of brands and styles available on the market (at least in the States). Too many young folk grow up thinking only Trojan, Durex and Lifestyles exist, and of that group that there are only one or two styles. Once exposed to Crown or Kimono or Beyond Seven or whatever else, both men and women can find their safer sex lives changed drastically and forever. Lastly, I think no comprehensive condom discussion can be had without a thorough dialogue about lube. Lube inside a condom and added to a vagina — and necessary for anal sex — can completely flip people’s notion of condoms being painful or uncomfortable. And again, we grow up often thinking that a lubricated condom is good enough on its own. Sometimes that’s true, but often it’s not. Thank you again for going beyond basic distribution and availability issues and highlighting the fact that condoms must be used to be effective, and that requires a much more complex view of the populations we’re working with and a renewed effort to rethink how we approach and execute truly comprehensive sex ed. I hope to encourage this discussion on my blog at http://www.condomologist.com and I strongly encourage others to weigh in.

  • jodi-jacobson

    Really good and thorough on the issues.

    Jodi

  • invalid-0

    ONE condoms have attractive packaging as well as many kinds of condoms
    don’t feel ashamed of buying them buy and use condoms don’t be stupid

  • http://www.lastminutereisen.co.at invalid-0

    Well you talk about using condoms in order to save your health or not to become pregnant. I think we have to distinguish between people who have many time sex with new partners and people who relay on their partners since many months or years. Sure big trust is even then necessary if you have sex without a condom.

  • invalid-0

    I very much appreciate your discussion on the dynamic between men and women and the use of female and male condoms. I agree with you on the point that women play an important role in male condom use and vice versa. However, I do feel that this may not be the case in all parts of the world. Thus, having a tool such as the female condom is very important in that it empowers women to be responsible for their own sexual health. In fact, it is the only tool that can be used by women to prevent HIV infection and pregnancy. You mention that “comprehensive sexual education” is important so that “social, environmental, and personal factors are taken into account.” I feel that this is especially pertinent when advocating the use of female condoms. The process of negotiation to use protection is affected by factors such as cultural values, personal values, and degree of sexual education. These factors most definitely come into play when it is the female that ultimately makes the decision to use the prophylactic, as in the case of female condoms. In many cultures, sexuality is still a taboo among females. In addition, established gender roles may make it difficult for women to push for the use of prophylactics. Programs that break through these cultural and societal values are very important so that proper negotiation for the use condoms can take place. The push for female condoms also changes the dynamic of the negotiations, for it is no longer the male that has to be “convinced” so to speak. Comprehensive sexual education, along with the advancement of female condoms can truly change the gender dynamic of prophylactic use, especially in developing countries.

    I was wondering whether you feel that the female condom can actually become as widely used as the male condom? To date, there is really just one major company making this type of contraceptive, and the FDA has only recently approved the second generation of female condom. I feel that there is still quite a long way to go before the female condom becomes as ubiquitous as the male condom.

  • invalid-0

    Check out ONE condoms, they feel great and look great. They have artist designed packaging and they also donate 5% of what they make. Check them out online!

  • http://www.niki.at invalid-0

    The threat of AIDS still persists and prevention aids like condoms are still important but I read many times that people loose their fear because medical help is getting better. Well better but it still can not “defeat” AIDS! So I appreciate blogs like yours which help to sensibilize people with AIDS and the importance of condoms. Kimberly, amazing blog!

  • http://www.lastminutereisen.co.at invalid-0

    If you have a new partnership you have also the responsibility to your new partner concerning health and safety. It is irresponsible if you have sex with your new partner without save precautions like condoms. The best way to be sure is to make a AIDS test but be aware that you only know after 90 days for sure the real answer. What I mean is even when the test is negative there is a little chance that it turn out positive after 2-3 month. This risk is because the body don´t raise immediately antibody.

  • farhaj

    WEll Now adays there are a lot ads going on everywhere regarding this issue and such ads should be seen and monitered properly to see weather they are reliable or should be banned.

    sea weed

  • flashstar

    I consider, that in this plan to be protected follows both to men, and women. Though all these means of contraception are not ideal… That you will prefer – depends only on you (taking into account a state of health of the woman).
    Partners should agree among themselves about a method of regulation of conception, having chosen the most suitable to both.

    Female health is necessary for saving first of all!

    After all it is impossible to make on hundred thousand abortions a year (if no more), justifying their inefficiency of contraceptive means.
    Surgical interruption of pregnancy (abortion) – so rough intervention in health and mentality of the woman what is compared with on harm any of contraception means cannot in no way.

    Conference more than is necessary, it is necessary more often…

  • http://profiles.friendster.com/cookinggames invalid-0

    What does a female condom looks like? I would really like to see one.

  • http://ohmywedding.info invalid-0

    I think it’s safe to say that this “dichotomy”
    between men / women and female condoms / male condoms is false, and
    both women and men have roles and responsibilities when it comes to
    negotiating and using female and male condoms.