Female Condoms: No Better Time Than Now

RH Reality Check is publishing a series of articles from the International AIDS Conference, taking place in Vienna, Austria, this week.

With yesterday’s announcement of a vaginal gel that can protect women from HIV transmission with a 39 percent success rate, women have a reason to cheer. Given that women account for 60 percent of all HIV infections in Sub-Saharan Africa, it is a cheer that is long overdue. And while we celebrate the announcement, we are also asking for more.

Women all over the world have expressed a demand for female condoms, yet the dual-protection method that, like the gel, is designed for women to initiate, is still grossly underfunded and under-supported by international and national donors and governments. On the same day news about the gel was announced at the XVII International AIDS Conference (AIDS 2010) in Vienna, women rallied in the media center to demonstrate the profound unmet need for female condoms in sub-Saharan Africa: Currently, there is one female condom available for every 300 women annually.

Female condoms remain the only tool that offers “dual protection,” in other words, it can protect against HIV and STIs and prevent pregnancy.  And it is in the control of women to use. However, female condoms are neglected in efforts to expand access to both HIV prevention and family planning services because they suffer from stigma and discrimination at the hands of those controlling the purse strings.

But consider this: Research conducted in Brazil, India, Thailand, the United States, and Zambia indicates an increase of protected sex acts, and a decrease in STIs, when both female and male condoms were available and well-marketed. Male condoms, while indispensable, are not enough. The combined availability of male and female condoms has proven to more effective at preventing HIV and other STIs than the sole availability of the male condom.

The point is to increase the range of options women can use. When women and men have a number of different ways to protect themselves, they do so more often. Were both male and female condoms made available and affordable–and accompanied by the new microbicides as these come to market–women and men would have a range of prevention options that would be to everyone’s benefit. We also cannot ignore that even with the introduction of the gel, the female condom remains the only dual-protection method that women can initiate. That is the hook, line and sinker. Women are increasingly vulnerable to HIV infection, but they are also vulnerable to unwanted or unintended pregnancy. We need to provide them with the option to save their own lives.

At a press conference Tuesday at AIDS 2010, we heard from Carol Nawina Nyrienda, national coordinator of the Community Initiative for TB, HIV/AIDS & Malaria (CITAM+) in Zambia, and a woman living with HIV.  She said:

 “As a woman, I am really happy about the news about microbicides, but as an HIV-positive woman it is too late for me. HIV-positive women still have sex. If you have access to a female condom, you can protect your partner, and you can protect yourself from reinfection and unwanted pregnancy.”

There is no downside to fully funding and supporting the expressed demand and unmet need for female condoms as an HIV-prevention method, and as a family planning method. If we stop and listen to women, this is what they are asking for, and we would be irresponsible to dismiss that. Today’s announcement about the gel is a significant breakthrough. If we combine it with full support for necessary prevention options, we could make it a turning point against HIV.

This is what women are asking for—it’s time that we answer.

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  • kate-steger

    I’m glad to hear that women are rallying to champion female condoms at the conference. In addition to the new gel, they are a great way to put family planning and HIV prevention in the hands of women. At the Women Deliver Conference in May, I caught Annet Neijmeier of Condoms4All on video giving a short demonstration of three different kinds of female condoms and posted it on the Pulitzer Center website: http://pulitzercenter.org/content/annet-neijmeier-universal-access-female-condom-joint-programme

    As Annet says, we need more choice and more availability!

  • daninmarina

    Los Angeles, CA;  NIH funding was awarded to Strata Various Product Design on July 1, 2010, for an 18 mo, Phase 1 Feasibility & Acceptability Study of a new female condom concept, the ORIGAMI Female Condom. This grant will help develop the device, conduct preclinical testing, conduct a User Preference Study and a Couples Acceptability & Performance Study.
    The study PI is the inventor, Daniel Resnic. The co-Investigator is Dr. Arianne van der Straten, director of the Women’s Global Health Imperative at RTI International in San Francisco. Our ultimate goals include contraception and STD prevention, which will be subsequently considered in a Phase II Study.
    Our objectives are two-fold; to place emphasis on pleasure while simultaneously improving safety. Our custom designed material was preclinically tested for biocompatibility and showed zero viral permeability to the Phi-X174 bacteriophage, one of the smallest known viruses.  In contrast, a leading brand of a male latex condom was tested with 5% viral permeability.  

    Following successful Phase I results, we anticipate additional feasibility studies in other regions of the world while we pursue Phase II research for FDA review.