Facts list on the female condom
The facts speak for themselves about the acceptability of the female condom, its effectiveness and the action that has to be undertaken. Female condoms exist now; the push for universal access to them should begin.
Background facts on the Millennium Development Goals (MDGs)
• The feminization of the HIV epidemic is a fact. In sub-Saharan Africa 61 percent of adults and 75 percent of young people infected with HIV are female.
• AIDS is a leading cause of mortality worldwide, with an estimated 2.1 million deaths in 2007.
• Investment in primary prevention will reduce the number of new HIV infections, and so reduce the cumulative growth in the numbers of people needing anti-retroviral treatment.
• UNFPA estimated that there are around 200 million women worldwide who would like to limit or space the children they have, but who are not using any form of contraception.
• WHO estimates that in developing countries more than one-third of all pregnancies are unintended.
• A fifth of those unintended pregnancies are aborted, more than half by unsafe means.
• Unsafe abortions cause five million women to be hospitalised each year, and account for 13 per cent of maternal deaths.
• In Sub-Saharan Africa, one in sixteen woman will die from the complications of pregnancy and childbirth. This is compared to one in 3,800 in the developed world.
• The global contraceptive prevalence has increased to 64 percent in 2005; it remains low in sub-Saharan Africa at just 21 per cent
Prevention
• Condoms – male and female – are currently the only available technology which gives users simultaneous protections against pregnancy and STI’s including HIV.
• Throughout the developing world an individual has easier access to anti-retroviral treatment than getting a reliable supply of female condoms.
• For every two people who are put onto anti-retroviral, another five new HIV infections occur
• Long experience of family planning shows that an increasing the choice of methods available leads to increased uptake and more consistent and continued contraceptive use.
• Providing female condoms alongside male condoms can help prevent HIV infection, and unintended pregnancy and help to empower women as is shown in case studies in Brazil, South Africa and Zimbabwe.
Availability:
• From 1993 to 2005 the only female condom was the Female Health Company FC.
• FC1 is now being replaced by FC2, those are the only two female condoms with WHO pre qualification
• Dr. Reddy female condom has not yet fulfilled all the requirements of the WHO pre-qualification procedure. It is approved for use throughout Europe and many other countries and around five million were sold commercially between 2003 and 2007.
• The PATH woman’s condom is under development and is seeking funding for trails to gain approval.
• Only 0.24 per cent of all condoms produced are female-condoms.
Benefits:
• Qualitative studies find an increased sense of power for negotiation of safer sex, and a greater sense of control and safety during sex, among women using female-condoms.
• Effective female-condom programming also enables women, men and health professionals to gain a better understanding of women’s bodies and a greater ability to discuss sexuality and safer sex.
• Female-condoms have the advantage of no side effects, are reversible forms of contraception, and can be used without seeking a health-care provider.
• Female-condoms offer more flexibility regarding the timing of putting them on (up to 8 hours before the sexual act) and taking them off.
• Synthetic female-condoms have a soft, moist texture which feels more natural during sex. For men the sensation is closer to that of sex without a condom, because female condoms do not fit tightly around the penis as male condoms do.
• Unlike latex condoms, synthetic female condoms are not damaged by oil based lubricants nor affected by changes in temperature and humidity, so they can be safely stored almost anywhere.
Costs:
• Female condoms have a unit cost about 18 times higher than male condoms. ($ 0,55 against $0,03)
• Female condoms (provided in addition to male condoms) enables an additional ten percent of protections. This additive effect makes female condoms cost-effective in comparison to male condoms.
• UNAIDS mathematical model shows that the female condom is a const-effective contraceptive and STI-prevention method. The cost of expanded female-condom programming against the treatment cost savings to be gained through HIV infections averted. This benefit increases substantially with scale.
• Around $10 billion funding available for responding to HIV globally in 2007, a forty-fold increase in a decade (page 4)
• The total funding on female condoms in 2007 has been no more than 0.3 per cent of the total funding for responding to HIV
Obstacles:
• Failure to promote and increase the production of female-condoms is due to: ignorance, culture, denial, “poverty” and conservatism:
• Ignorance causes poorly informed decision makers to rely on media stereotypes regarding female condoms rather than scientific studies.
• Culture creates a sometimes explicit bias to female condoms; the personal beliefs and values of a few individuals often prevail over an evidence informed policy guidance.
• Denial allows sceptics to argue that the female-condom is just an expensive condom that still requires negotiation. Moreover, it permits ignorance towards the men who don’t like to use male condoms, and prefer female-condoms.
• “Poverty” and the claim that female-condoms are not affordable are the most publically acceptable reasons for failing to make female-condoms accessible. Yet with funding of $10bn for responding to HIV in 2007, this ‘poverty’ is more of a failure to find money for female-condoms.
• Conservatism has led to psychological discomfort for some regarding women taking control of their bodies and their sexuality through the use of the female-condom.
• Lack of leadership within the UN and the majority of donor agencies has resulted in a sporadic and uncoordinated global effort to develop and promote female-condoms.
• Failure to scale up long term female-condom programming has resulted in short term fund trials, pilot programmes and studies that have a low quality of programming and frequently leave countries out of stock of female-condoms.
Recommendations for Change:
• Reduce the price of female-condoms. This can achieved by creating demand, investing in new designs, encouraging the not-for profit production of female-condoms, and allowing generic versions of female-condoms to be produced.
• Create visible global leadership through the collaboration of UNAIDS, UNFPA, and donor and development organizations. Use this global leadership to promote female-condoms as a contraceptive and a prevention method against STIs including HIV. Moreover, work to raise the female-condom distribution rate and lower the cost.
• Incorporate the female-condom within the gender and health policies of UN agencies and international donors. Incorporation of such would significantly boost investment.
• Support female-condom research and development. Variety is needed because it is not one size fits all. Moreover a new female condom is needed to increase demand and will reduce the price.
• Create comprehensive long-term integrated female-condom programming. National governments, civil society organizations, and the private sector should collaborate to create programming and thus work to make female condoms available to all women and men.
