Expanding Access to the Female Condom

Women represent over 47 percent of those infected with HIV worldwide, and will soon make up the majority. Each day, millions of women around the world are put at risk of HIV infection from unprotected sexual intercourse. Greater focus is urgently needed on strategies that address women's disproportionate risk of infection, enable them to negotiate safe sex, and provide tools, such as female condoms, to protect themselves from infection. Women and girls remain at risk because they are economically and socially dependent on husbands or partners, are at risk of sexual coercion and violence, and have little power to negotiate safe sex.

In sub-Saharan Africa, the hardest hit region, women account for more than 55 percent of all infections. "In India, where HIV is spreading rapidly, current data from UNAIDS and India's National AIDS Control Organization reveal that women make up at least one quarter of all HIV infections," states Avni Amin, Senior Program Associate at CHANGE. The female condom is the only existing method of STI and HIV prevention that can be initiated and controlled by women. Data show that the female condom is a highly effective barrier against transmission of HIV and many other sexually transmitted infections. Consistent and correct use of the female condom reduces the risk of sexually transmitted infection (including HIV) by between 94% and 97% per act of intercourse. In addition, the female condom allows women to simultaneously protect themselves from unwanted pregnancy.

Studies from several countries indicate that with appropriate levels of education, training, and support, women find the female condom both effective and empowering, allowing them to negotiate safe sex. In Ghana, observes Alice Lamptey, National Coordinator of the Society for Women and AIDS in Africa (SWAA)-Ghana, "it is accepted that men can do what they like with their wives and girlfriends. We had to find a way to protect women, and we found the female condom." Ghana's female condom program is currently one of the most successful in the world.

Cost, lack of knowledge of the method, and provider biases are the most important impediments to increased access to the female condom worldwide. The female condom sells for roughly U.S. 55 cents per unit, which is clearly too high for sustained use in many settings. This is partly related to the lack of public sector investment in this method by governments or international donor agencies. The United States and other donor countries could dramatically reduce HIV transmission by investing in expanded access to the female condom and the programs needed to support sustained use worldwide. By investing in strategies to support expanded use of the female condom, we can start saving lives right now!

Ishdeep Kohli-CNS