Introduction of the female condom in Southern AfricaBy Caroline MaposhereGender, Sexual and Reproductive Health Consultant

Polyurethane

Presentation outline

Background – HIV epidemic in Southern Africa

The Zimbabwe story

Introduction at ICASA IN 1995

Acceptability studies

Advocacy for registration

Social marketing

Advocacy for availability

Lessons learnt

HIV in Southern Africa

HIV Epidemic in Southern Africa

• Factors that fuel the epidemic

Low or no condom use

Large number of infected people not on treatment

Multiple concurrent partnerships

Underlying factors that fuel the spread of HIV in the region?

gender inequality

poverty

cultural and religious beliefs

legal and policy environment

Story of Zimbabwe

WHO consignment to the University of Zimbabwe –Department of Community Medicine

Female condom discussion at ICASA – 1995

Introduction of the condom

Presentation room full – people were curious

Insertion demonstration

Acceptability studies

Urban studies –

Sex workers

Taxi drivers

Rural studies

Married women

Acceptability studies cont…..

Added advantages of the female condom

Female initiated and controlled

Stronger

More natural feel

Excitation from the rings

Timing of insertion and removal

Advocacy for registration

Dissemination of acceptability study findings

Women and AIDS Support Network

Collection of signatures

Lobby Female Deputy Minister of health

Registration of the female condom - 1998

Social Marketing

PSI – Care Contraceptive Sheath

Interpersonal communication approach

– hair salons, community peer educators

Advocacy for availability

Female condom strategy

As part of national HIV prevention strategy as well as dual protection aspect

All condom distribution discussions include male and female condoms

Intensive training sessions for service providers at all levels

Availability – re use

WHO guidelines

Soaking the condom in a 1:20 solution of household bleach for between two and five minutes

Washing the condom in soap and water to remove all traces of bleach, lubricant and ejaculate.

Air-drying the condom, turning it inside out to ensure both sides are dry.

Re-lubricating, preferably with silicone or water-based lubricants, though with the polyurethane condom alone oil-based ones such as petroleum jelly, baby oil, and vegetable oil or fat.

Condoms should be reused no more than five times

Lessons learnt

Linked research and advocacy to strengthen political movement with evidence - Integrate into health care system as evidence based programming and train service providers as part of Sexual and Reproductive Health

The barriers that exist for male condom use, also exist for the female condom

Lessons learnt cont….

Need for accompanying assertive training for women and girls to increase uptake for their benefit – not just as a public health agenda but a gender issue

Gender issue – hence engage pressure groups that are working on women empowerment issues

Lessons leant cont….

Use the changing the rivers flow model

Using community dialogues, interrogate sexual norms and see where safety, satisfaction and negotiation fit in patriarchal societies

modify existing and deep rooted cultural practices

male involvement for the benefit of women and girls i.e. men as protectors

Thank you