Female Condoms: The Missing Prevention Method

Lauren R. S. Mendonsa

In 2006, only one female condom was available for every 100 women worldwide. This disturbing fact won't surprise anyone who's ever tried to locate female condoms. My first attempt to purchase them resulted in a confused pharmacy technician showing me various spermicidal gels, vaginal sponges and a male condom marketed for women. Before traipsing to pharmacies across DC, I decided to call around. Of the 22 locations I called, 12 of which were pharmacies, only five carried female condoms: two Planned Parenthoods, two student health centers, and an HIV/AIDS clinic. None of these locations were open after business hours and the closest provider was a 20-minute metro ride from my office.

The fact that I had to traverse the city to find a female condom points to greater problems than those presented for sexual spontaneity. This experience starkly highlights a failure to market and distribute one of the most effective prevention methods, and the only available female-controlled method, against the sexual transmission of HIV.

In 2006, only one female condom was available for every 100 women worldwide. This disturbing fact won't surprise anyone who's ever tried to locate female condoms. My first attempt to purchase them resulted in a confused pharmacy technician showing me various spermicidal gels, vaginal sponges and a male condom marketed for women. Before traipsing to pharmacies across DC, I decided to call around. Of the 22 locations I called, 12 of which were pharmacies, only five carried female condoms: two Planned Parenthoods, two student health centers, and an HIV/AIDS clinic. None of these locations were open after business hours and the closest provider was a 20-minute metro ride from my office.

The fact that I had to traverse the city to find a female condom points to greater problems than those presented for sexual spontaneity. This experience starkly highlights a failure to market and distribute one of the most effective prevention methods, and the only available female-controlled method, against the sexual transmission of HIV.

When used correctly and consistently, the female condom is as effective as the male condom in preventing HIV. Additionally, the female condom remains the only new form of STI prevention developed since the advent of the AIDS epidemic. Since that time, the world has experienced a feminization of the disease: worldwide, 17.3 million women over 15 are infected with HIV, and 76% of HIV-positive youth in sub-Saharran Africa are female. While the majority of new HIV infections occur in developing countries, women in the United States are not exempt from the scourge of this disease: AIDS is the leading cause of death for African American women aged 25-34. Such conditions demand a female-controlled prevention method.

To address this demand, public and private entities like USAID and the Bill and Melinda Gates Foundation have begun investing millions of dollars into research on microbicides—undetectable gels and creams that women could apply vaginally to protect themselves from the sexual transmission of HIV. Because they are undetectable and could be applied prior to intercourse, microbicides present distinct advantages for women with partners who oppose protection. However, UNAIDS estimates that a microbicide won't be ready for general use for another five to seven years. Additionally, the recent halting of two phase III microbicide trials due to product failure reminds us that these yet-to-be-developed technologies are still a promise of the future and further underscores the immediate need to enable women to protect themselves with prevention technologies currently available.

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The unit cost of female condoms—approximately $0.60—is often cited as a barrier to distribution. However, estimates predict that increasing female condom distribution from the present 20 million-per-year to 200 million-per-year would decrease their cost by two-thirds, making them cost-competitive with male condoms. To date, donors have spent $163 million on microbicide research. According to a study published by Johns Hopkins University, one-fifth that amount could purchase over 50,000,000 female condoms and prevent as many as 32,000 new HIV infections in South Africa. Imagine the savings to South Africa's healthcare system if the country had 32,000 fewer HIV cases. Imagine the savings for human life.

This is not a matter of pitting research budgets against procurement budgets, but rather of doing everything in our power to fund the distribution of an effective HIV prevention method that women and men worldwide can start using now.

Female condoms provide an alternative to the male condom and allow women to bring a protection option to the table (or bed, if you will). Additionally, research has shown that couples' ability to switch between male and female condoms leads to an increase in the total number of protected sexual acts. Most importantly, female condoms are available now—they can start curbing the spread of HIV and saving lives today.

Organizations and communities must demand access to female condoms. Zimbabwe only began importing female condoms after women's groups presented their government with 30,000 women's signatures demanding access to them. Such grassroots and community action needs to take place around the world. PreventionNow is an international campaign to ensure universal access to female condoms led, in the United States, by the Center for Health and Gender Equity. You can join this network of thousands of people and more than 175 domestic and international organizations committed to building grassroots and donor support for female condoms at PreventionNow.net. By enabling and empowering women to protect themselves and their partners with female condoms, we can begin saving lives and curbing the spread of HIV today.

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