How misinformation has affected uptake of female condom

The female condom reduces the risk of HIV infection by 94–97%.

In Summary

•Also perceptions of a female condom proposer may  be more negative than a male proposer, as this would indicate higher power in the sexual situation, a violation of gender roles. 

•The unpopularity of the female condom seem to orignate from how unfamiliar it is to the public, apart from the government ensuring they are available, socially marketed and affordable  , there is need for extensive campaigns and not just on the basics of using a female condom but also on how to negotiate safe sex with a patner.

A female condom
A female condom
Image: ANDREW KASUKU

The HIV infections among women is twice that of men.

Young women between the ages of 20-34 years are three times as likely than their male peers to get infected with HIV.

Condom use is one of the methods that governments worldwide have been advocating to protect oneself against HIV and other sexually transmitted diseases as well as preventing unintended pregnancies.

Female condoms, which were first introduced in Kenya 25 years ago, have received surprisingly little serious attention.

Given the global number of HIV-positive women, international support for women's reproductive and sexual health and rights, and, not least, user demand, one would have expected the female condom to be widely available. Instead, the female condom has been marginalised in the international response to HIV and AIDS.

When used correctly and consistently, the female condom reduces the risk of HIV infection by 94–97%. Female condoms are extremely effective at increasing protected sex and decreasing HIV and STI incidents. A significant number of studies have also shown that a diverse range of contraceptive methods and STI/HIV prevention devices can help achieve safer sex practices. The female condom is the only method that allows women to control protecting themselves and their partners. It can empower women, give them a greater sense of self-reliance and autonomy, and enhance dialogue and negotiation with their sexual partners.

Male condom use for pregnancy prevention has been promoted successfully in Africa among young, single women aged 15–24 who are at high risk of HIV in Kenya due to sexual networking patterns. Although many couples could have benefited from the female condom's dual protection, many of them have never heard of it, and if they have heard of it, they are unable to obtain it as it is not widely available. Female condom production remains a very small fraction (0.28 percent) of total condom production, and access to this protective device is haphazard and insufficient.

Kenya's HIV prevalence declined from 5.9 percent in the 2018-19 fiscal year to 4.8 percent in 2019-20 as the government stepped up measures to fight the disease, this is according to a report released in November 2020 by the Ministry of Health.

 However, infection rates among young people (15-24) remain concerning. In 2020, they accounted for 35 per cent of new infections, with two thirds of cases among young women. 

Preliminary findings by the Kenya Population-based HIV Impact Assessment 2018  showed that the prevalence of HIV in women is at 6.6%, twice that in men at 3.1%. The gender disparity in the burden of HIV is  three times among women and men aged 20-34 years.

Condom use is considered one of the most effective ways of preventing unwanted pregnancies and the transmission of HIV, the virus that causes AIDS. The most popular and accessible type of condom is the male (external) condom. Condoms also reduce the risk of infection from other STIs such as gonorrhoea and chlamydia. All over the world, condoms (or some sort of condom-like devices) have been used as the main tool to prevent venereal diseases and pregnancy,  for millennia. These condoms ranged from  linen sheaths in ancient Egypt to animal intestines, pig bladders, to thin leather, thin leather, oiled paper (China)

Male condoms are 98% effective when they are used properly. This means 2 out of 100 people will become pregnant in 1 year when male condoms are used as contraceptive.According to the National AIDS Control Council, the uptake of condoms within the age group of 15-29 years who accounted for 62%  of total HIV new transmission in 2019  is quite wanting, with females accounting for only 37.5% of condom use compared to their male counterparts who account for 68.9%.

Image: AWPJ

Female condoms were introduced in the Kenyan market 25 years ago but are not as popular as the male condom. The reason for this is because many women and girls are unaware of the existence of the female condom, they are not easily accessible and they are also unaffordable as they cost more than a male condom. These challenges deny women one of the few means over which they have control of protecting themselves against HIV and STIs or preventing unintended pregnancies.

A female condom is a soft plastic  material used as a barrier – inserted into the vagina – to prevent bodily fluids and semen from entering the body.It is  made from a nitrile polymer synthetic material (non-latex) sheath  that   quickly warms up to body temperature so sex feels more natural and can be inserted in advance  and used within the couple of hours.

Female condoms are not socially marketed in Kenya,so you can not purchase them from a pharmacy or supermarket, but are available at no cost at government health facilities.

Though there have been reports of them being sold for up to Sh300, says Bethryn Kitavi, a regional technical advisor at RHFP who regularly does training on the use of female condoms in communities.

According to the Ministry of Health’s data analytics platform which aggregates information from all public health facilities , only  5,800 pieces of female condoms were dispensed from health facilities countrywide in 2020.

Besides the myths about the use and the effectiveness of the female condom there are  gender and cultural stereotypes that can be attributed to the low uptake of female condoms.

Sexual double standards such that women are judged harshly for the same sexual activities for which men are lauded and  when it comes to who is proposing the use of condom, while the men are seen as mature and being careful, the perception is different and negative when it is a woman proposing use of condom during a sexual encounter especially in commital relationships with women being seen as promscious.

There  is also the  fear by women of violating traditional gender roles of condom use behavior, even though women participate in negotiating safe sex, it is a bit more complex for them to equally participate because of the nature of the society which is partriachal and cultural practices like bride prices that affect the quality of decision making  especially in marital relationships.

Also perceptions of a female condom proposer may  be more negative than a male proposer, as this would indicate higher power in the sexual situation, a violation of gender roles. 

The unpopularity of the female condom seem to orignate from how unfamiliar it is to the public, apart from the government ensuring they are available, socially marketed and affordable  , there is need for extensive campaigns and not just on the basics of using a female condom but also on how to negotiate safe sex with a patner.

Efforts to resolve the challenges affecting uptake of  the female condom will offer the best chance to recognize  its potential as a female-initiated barrier method and lay the groundwork for the promotion of other female-initiated barrier methods for HIV and STI prevention, not negating the fact that it is the only existing method that  allows women to have more control of their safe sex practices and  participate fully in family planning, as well as HIV and STI prevention.

This article was produced by the Africa Women’s Journalism Project in partnership with Article 19, Meedan and the International Centre for Journalists. 

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