Female and Male Condoms: Whose Responsibility?

Kimberly Whipkey

Female condoms for women, male condoms for men? Not so fast!

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. 

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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! 

News Human Rights

What’s Driving Women’s Skyrocketing Incarceration Rates?

Michelle D. Anderson

Eighty-two percent of the women in jails nationwide find themselves there for nonviolent offenses, including property, drug, and public order offenses.

Local court and law enforcement systems in small counties throughout the United States are increasingly using jails to warehouse underserved Black and Latina women.

The Vera Institute of Justice, a national policy and research organization, and the John D. and Catherine T. MacArthur Foundation’s Safety and Justice Challenge initiative, released a study last week showing that the number of women in jails based in communities with 250,000 residents or fewer in 2014 had grown 31-fold since 1970, when most county jails lacked a single woman resident.

By comparison, the number of women in jails nationwide had jumped 14-fold since 1970. Historically, jails were designed to hold people not yet convicted of a crime or people serving terms of one year or less, but they are increasingly housing poor women who can’t afford bail.

Eighty-two percent of the women in jails nationwide find themselves there for nonviolent offenses, including property, drug, and public order offenses.

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Overlooked: Women and Jails in an Era of Reform,” calls attention to jail incarceration rates for women in small counties, where rates increased from 79 per 100,000 women to 140 per 100,000 women, compared to large counties, where rates dropped from 76 to 71 per 100,000 women.

The near 50-page report further highlights that families of color, who are already disproportionately affected by economic injustice, poor access to health care, and lack of access to affordable housing, were most negatively affected by the epidemic.

An overwhelming percentage of women in jail, the study showed, were more likely to be survivors of violence and trauma, and have alarming rates of mental illness and substance use problems.

“Overlooked” concluded that jails should be used a last resort to manage women deemed dangerous to others or considered a flight risk.

Elizabeth Swavola, a co-author of “Overlooked” and a senior program associate at the Vera Institute, told Rewire that smaller regions tend to lack resources to address underlying societal factors that often lead women into the jail system.

County officials often draft budgets mainly dedicated to running local jails and law enforcement and can’t or don’t allocate funds for behavioral, employment, and educational programs that could strengthen underserved women and their families.

“Smaller counties become dependent on the jail to deal with the issues,” Swavola said, adding that current trends among women deserves far more inquiry than it has received.

Fred Patrick, director of the Center on Sentencing and Corrections at the Vera Institute, said in “Overlooked” that the study underscored the need for more data that could contribute to “evidence-based analysis and policymaking.”

“Overlooked” relies on several studies and reports, including a previous Vera Institute study on jail misuse, FBI statistics, and Rewire’s investigation on incarcerated women, which examined addiction, parental rights, and reproductive issues.

“Overlooked” authors highlight the “unique” challenges and disadvantages women face in jails.

Women-specific issues include strained access to menstrual hygiene products, abortion care, and contraceptive care, postpartum separation, and shackling, which can harm the pregnant person and fetus by applying “dangerous levels of pressure, and restriction of circulation and fetal movement.”

And while women are more likely to fare better in pre-trail proceedings and receive low bail amounts, the study authors said they are more likely to leave the jail system in worse condition because they are more economically disadvantaged.

The report noted that 60 percent of women housed in jails lacked full-time employment prior to their arrest compared to 40 percent of men. Nearly half of all single Black and Latina women have zero or negative net wealth, “Overlooked” authors said.

This means that costs associated with their arrest and release—such as nonrefundable fees charged by bail bond companies and electronic monitoring fees incurred by women released on pretrial supervision—coupled with cash bail, can devastate women and their families, trapping them in jail or even leading them back to correctional institutions following their release.

For example, the authors noted that 36 percent of women detained in a pretrial unit in Massachusetts in 2012 were there because they could not afford bail amounts of less than $500.

The “Overlooked” report highlighted that women in jails are more likely to be mothers, usually leading single-parent households and ultimately facing serious threats to their parental rights.

“That stress affects the entire family and community,” Swavola said.

Citing a Corrections Today study focused on Cook County, Illinois, the authors said incarcerated women with children in foster care were less likely to be reunited with their children than non-incarcerated women with children in foster care.

The sexual abuse and mental health issues faced by women in jails often contribute to further trauma, the authors noted, because women are subjected to body searches and supervision from male prison employees.

“Their experience hurts their prospects of recovering from that,” Swavola said.

And the way survivors might respond to perceived sexual threats—by fighting or attempting to escape—can lead to punishment, especially when jail leaders cannot detect or properly respond to trauma, Swavola and her peers said.

The authors recommend jurisdictions develop gender-responsive policies and other solutions that can help keep women out of jails.

In New York City, police take people arrested for certain non-felony offenses to a precinct, where they receive a desk appearance ticket, or DAT, along with instructions “to appear in court at a later date rather than remaining in custody.”

Andrea James, founder of Families for Justice As Healing and a leader within the National Council For Incarcerated and Formerly Incarcerated Women and Girls, said in an interview with Rewire that solutions must go beyond allowing women to escape police custody and return home to communities that are often fragmented, unhealthy, and dangerous.

Underserved women, James said, need access to healing, transformative environments. She cited as an example the Brookview House, which helps women overcome addiction, untreated trauma, and homelessness.

James, who has advocated against the criminalization of drug use and prostitution, as well as the injustices faced by those in poverty, said the problem of jail misuse could benefit from the insight of real experts on the issue: women and girls who have been incarcerated.

These women and youth, she said, could help researchers better understand the “experiences that brought them to the bunk.”

Culture & Conversation Family

‘Abortion and Parenting Needs Can Coexist’: A Q&A With Parker Dockray

Carole Joffe

"Why should someone have to go to one place for abortion care or funding, and to another place—one that is often anti-abortion—to get diapers and parenting resources? Why can’t they find that support all in one place?"

In May 2015, the longstanding and well-regarded pregnancy support talkline Backline launched a new venture. The Oakland-based organization opened All-Options Pregnancy Resource Center, a Bloomington, Indiana, drop-in center that offers adoption information, abortion referrals, and parenting support. Its mission: to break down silos and show that it is possible to support all options and all families under one roof—even in red-state Indiana, where Republican vice presidential candidate Gov. Mike Pence signed one of the country’s most restrictive anti-abortion laws.

To be sure, All-Options is hardly the first organization to point out the overlap between women terminating pregnancies and those continuing them. For years, the reproductive justice movement has insisted that the defense of abortion must be linked to a larger human rights framework that assures that all women have the right to have children and supportive conditions in which to parent them. More than 20 years ago, Rachel Atkins, then the director of the Vermont Women’s Center, famously described for a New York Times reporter the women in the center’s waiting room: “The country really suffers from thinking that there are two different kinds of women—women who have abortions and women who have babies. They’re the same women at different times.”

While this concept of linking the needs of all pregnant women—not just those seeking an abortion—is not new, there are actually remarkably few agencies that have put this insight into practice. So, more than a year after All-Options’ opening, Rewire checked in with Backline Executive Director Parker Dockray about the All-Options philosophy, the center’s local impact, and what others might consider if they are interested in creating similar programs.

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Rewire: What led you and Shelly Dodson (All-Options’ on-site director and an Indiana native) to create this organization?

PD: In both politics and practice, abortion is so often isolated and separated from other reproductive experiences. It’s incredibly hard to find organizations that provide parenting or pregnancy loss support, for example, and are also comfortable and competent in supporting people around abortion.

On the flip side, many abortion or family planning organizations don’t provide much support for women who want to continue a pregnancy or parents who are struggling to make ends meet. And yet we know that 60 percent of women having an abortion already have at least one child; in our daily lives, these issues are fundamentally connected. So why should someone have to go to one place for abortion care or funding, and to another place—one that is often anti-abortion—to get diapers and parenting resources? Why can’t they find that support all in one place? That’s what All-Options is about.

We see the All-Options model as a game-changer not only for clients, but also for volunteers and community supporters. All-Options allows us to transcend the stale pro-choice/pro-life debate and invites people to be curious and compassionate about how abortion and parenting needs can coexist .… Our hope is that All-Options can be a catalyst for reproductive justice and help to build a movement that truly supports people in all their options and experiences.

Rewire: What has been the experience of your first year of operations?

PD: We’ve been blown away with the response from clients, volunteers, donors, and partner organizations …. In the past year, we’ve seen close to 600 people for 2,400 total visits. Most people initially come to All-Options—and keep coming back—for diapers and other parenting support. But we’ve also provided hundreds of free pregnancy tests, thousands of condoms, and more than $20,000 in abortion funding.

Our Hoosier Abortion Fund is the only community-based, statewide fund in Indiana and the first to join the National Network of Abortion Funds. So far, we’ve been able to support 60 people in accessing abortion care in Indiana or neighboring states by contributing to their medical care or transportation expenses.

Rewire: Explain some more about the centrality of diaper giveaways in your program.

PD: Diaper need is one of the most prevalent yet invisible forms of poverty. Even though we knew that in theory, seeing so many families who are struggling to provide adequate diapers for their children has been heartbreaking. Many people are surprised to learn that federal programs like [the Special Supplemental Nutrition Program for Women, Infants, and Children or WIC] and food stamps can’t be used to pay for diapers. And most places that distribute diapers, including crisis pregnancy centers (CPCs), only give out five to ten diapers per week.

All-Options follows the recommendation of the National Diaper Bank Network in giving families a full pack of diapers each week. We’ve given out more than 4,000 packs (150,000 diapers) this year—and we still have 80 families on our waiting list! Trying to address this overwhelming need in a sustainable way is one of our biggest challenges.

Rewire: What kind of reception has All-Options had in the community? Have there been negative encounters with anti-choice groups?

PD: Diapers and abortion funding are the two pillars of our work. But diapers have been a critical entry point for us. We’ve gotten support and donations from local restaurants, elected officials, and sororities at Indiana University. We’ve been covered in the local press. Even the local CPC refers people to us for diapers! So it’s been an important way to build trust and visibility in the community because we are meeting a concrete need for local families.

While All-Options hasn’t necessarily become allies with places that are actively anti-abortion, we do get lots of referrals from places I might describe as “abortion-agnostic”—food banks, domestic violence agencies, or homeless shelters that do not have a position on abortion per se, but they want their clients to get nonjudgmental support for all their options and needs.

As we gain visibility and expand to new places, we know we may see more opposition. A few of our clients have expressed disapproval about our support of abortion, but more often they are surprised and curious. It’s just so unusual to find a place that offers you free diapers, baby clothes, condoms, and abortion referrals.

Rewire: What advice would you give to others who are interested in opening such an “all-options” venture in a conservative state?

PD: We are in a planning process right now to figure out how to best replicate and expand the centers starting in 2017. We know we want to open another center or two (or three), but a big part of our plan will be providing a toolkit and other resources to help people use the all-options approach.

The best advice we have is to start where you are. Who else is already doing this work locally, and how can you work together? If you are an abortion fund or clinic, how can you also support the parenting needs of the women you serve? Is there a diaper bank in your area that you could refer to or partner with? Could you give out new baby packages for people who are continuing a pregnancy or have a WIC eligibility worker on-site once a month? If you are involved with a childbirth or parenting organization, can you build a relationship with your local abortion fund?

How can you make it known that you are a safe space to discuss all options and experiences? How can you and your organization show up in your community for diaper need and abortion coverage and a living wage?

Help people connect the dots. That’s how we start to change the conversation and create support.

This interview has been edited for length and clarity.

CORRECTION: This article has been updated to clarify the spelling of Shelly Dodson’s name.

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