Questions on Female Condoms

[Guest guest]

Dear Forum members,

There has been considerable debate on female condoms, however, I for one am

still unclear about the following issues. I would appreciate clarification on

the following questions

1) What is the current price of female condoms in India -- retail and wholesale?

and what is it expected to be in 2 years?

2) How comfortable and easy are female condoms to use in settings outside of

sexwork?

3) How prevalent is the view recently reported by Dr Rajesh Buddhadev that even

men favor female condoms (this I presume is an extension of the prevalent

attitude that pregnancy and disease prevention are a women's responsibilty)?

4) In sex work setting -- since a female condom can be used mutiply -what is the

risk of vaginal infection on reuse after washing with (i)

water, (ii) water and soap but not sterilized in either case?

5) In sex work setting -- what is the risk of infection to second, third,

customer if the semen/sperm of the first carries HIV or other bacteria/virus

that cause STIs?

6) Are sex workers being trained to clean/sterilize condoms between each

customer or use microbicides or both?

Thanks

rajan gupta

rajan@...

http://t8web.lanl.gov/people/rajan/AIDS-india/

[Guest guest]

Dear Forum,

I attended the launch of the Female condom at Delhi in Feb 2004, the gist of it

given below. Hope it answers most of your questions. Washing the condom with

bleaching solution of a particular concentration is suggested for reuse but not

recommended. Soap and water alone is not enough and It was also discussed that

in limited water availability settings to get one bucket to wash the FC once

might be difficult.

Options for the woman, at last or Women can now call the shots

Friday 13th February 2004, saw another path breaking option offered to the

traditionally subdued woman- THE FEMALE CONDOM launched in Delhi, the Capital

city of India. The event took place at Taj Palace, Delhi in the presence of Mr

Chandrasekhar, the Chairman Hindustan Latex Limited and Dr Ann Leeper, COO

Family Health Company, UK.

4.58 million people were infected with HIV/AIDS in India and half of them are

women. Heterosexual transmission accounts for more than 80% of the cases. Nearly

25% of new HIV infections are occurring in women every year with an accompanying

increase in vertical transmission.

The predicaments of women in this male dominated society are mainly due to lack

of negotiating power of women in convincing the male to use protection during

sex. Women needed the confidence in decision-making regarding reproduction and

protective sex without relying upon the charity of men. The female condom

promises to empower women in effectively protecting them against Sexually

transmitted diseases and unwanted pregnancies.

Introduction of a women-oriented instrument is bound to have many barriers. This

could involve the Himalayan task of changing attitudes, behaviours,

deep rooted biases, gender disparities while addressing the stigma of using any

condom, male or female.

Hindustan Latex Limited therefore had done an acceptability study in three

states of Maharashtra, Andra Pradesh and Kerala amongst 3 sets of target groups,

namely Female Sex Workers (FSWs), Men-who- have- Sex- with-Men (MSMs) and

Eligible Couples(EC), all counseled volunteers. The intention of this study was

to find out the acceptability of Female Condom as an additional option to the

male condom that will contribute to increasing protection against STDs and HIV

infection. Of the total of 717, 337 were FSWs, 136 MSMs and 202 were ECs.

The Female Condom is a soft transparent polyurethane sheath inserted in the

vagina hours before sexual intercourse. It seems to have the same percentage of

protection as a male condom that is dependant on correct and consistent use.

The female condom is manufactured by The Female Health Company and is marketed

by the Hindustan Lever Limited as Confidom and Rani in India, through commercial

venues and through social marketing. The volume of sales that the company

intends to target in the coming year is 1 million.

At present, the cost of a single condom is Rs 45,and the company is hoping to

bring it down to Rs 20/25 after negotiations with the Government, while the

NGOs who took part in the study and who have access to the users say that at

most they can be sold at Rs 3/ or be given free. The company hopes that the

Government through its agencies such as The Family Planning Association of India

and the National AIDS Control Organisation, would make it a policy to distribute

free/subsidized female condoms to the target/High-risk groups as part of its

welfare programme. This could prevent new infections and lessen the burden of

providing ARVs. Indigenous production would start in a phased manner in the

coming years.

It has been shown that during the study of female condoms, the use of male

condoms increased considerably. The explanation given by one of the NGO was: Man

being chauvinistic, preferred to be in control of this situation of protective

sex and that he’d rather use the condom instead of letting the

female take the lead? The NGOs also pointed out that the female condoms have a

high acceptability rate with the FSWs when men refuse condom use or when they

are drunk. They also earned more if they allowed the partners to insert the

condom, which the latter found desirous.

The MSM group said though called a female condom, the right to use the product

is more important than the gender issue of the name. The trainers found that

since the condom is sturdier, the penetrating partner among MSMs also uses it

instead of the usual male condom.

The study seems promising with 90% usage with increased negotiating capability

endowed to the empowered women. Will these benefits outweigh the prohibitive

remains to be seen? Any new initiative is welcome while we wait for the panacea,

the HIV ”Vaccine”, till the end of the decade.

Shobha

E-mail:drshobhav@...