May 2002

The Female Condom:
Dynamics of Use in Urban Zimbabwe

Key Findings

Characteristics of respondents. Users of the female condom were generally in their mid- to late twenties and, compared to male condom users and non-users of either method, had higher levels of education and access to household resources. Among women, more users of the female condom were unmarried and were primary breadwinners in their households, compared to male condom users and non-users. A higher percentage of men who had used the female condom were married, compared to male users of the male condom. The vast majority of men and women used the male condom at least once prior to trying the female condom. More than half of male users of the female condom but only 17 percent of female users reported having more than one sexual partner within the last year.

Context of use. Use of the female condom was higher within the context of marriage or regular partnerships, rather than casual or commercial partnerships. For example, 77 percent of married men used a female condom with their spouse while only 45 percent (13/29) of married men who reported having a casual partner in the last year had used a female condom with that type of partner. Nearly 98 percent of unmarried women who had a regular partner reported using a female condom with them. But only 73 percent (22/30) of unmarried women who had had a casual partner in the last 12 months used a female condom within that relationship (73 percent).

Reasons for use. Novelty or experimentation and pregnancy prevention were primary reasons for initial use of the female condom (Figure 1). However, a third of men and 21 percent of women reported STI/HIV prevention as a motivator for trying the female condom. Qualitative data highlighted the importance of STI/HIV prevention as a main reason for using the female condom in general. For example, the majority of both male and female focus group participants mentioned disease prevention as the main reason they have continued to use the female condom.

Radio and friends or relatives were important sources of information about the female condom, but face-to-face contact—with either partners, friends, relatives, or health professionals—was an important motivator of actual use.

Perceptions and problems. Users of the female condom perceived it to be effective and reliable as both an STI/HIV prevention method and a contraceptive method. But 30 percent of men and 57 percent of women reported some difficulty with use, such as problems with insertion, discomfort during sex, noise or squeakiness during use, and excess lubrication. Many male and female in-depth interview participants (13/16) reported difficulties using the female condom upon initial use, but most had overcome these difficulties by the third or fourth use.

Negotiation of the female condom. Both male and female users concur that women, more than men, initiate dialogue about using the female condom, decide on its use, and procure the pro-duct. However, a considerable percentage of both males and females reported that both partners jointly decide to use the female condom. Pregnancy prevention and disease prevention are the most common topics discussed by survey participants in the negotiation process. However, focus group and in-depth interview data reveal that while some women, particularly married women, are interested in the female condom for disease prevention, they are not comfortable discussing this openly with their partner. Instead, they re-ported using other strategies, such as telling their partner that sex would be more enjoyable with a female condom than with a male condom, or that sex would be possible during menstruation.

An interesting finding is that 13 percent of women reported using the female condom without their partners’ knowledge. While this suggests that for some women the female condom can be totally under their control, in most cases the female condom requires communication with and cooperation from a woman’s partner.

Nearly a fourth of women and 15 percent of men said that one of their partners had opposed female condom use. While most say they used a male condom instead, among married women about half whose partner opposed using the female condom had unprotected sex.

Use of the female condom. Overall, about 15 percent of women and men reported always using the female condom (Table 1). Consistent use was reported much less frequently with spouses than with regular partners outside of marriage. Results from multivariate logistic regression demonstrate consistent female condom users were less likely to experience difficulties with use or partner opposition to female condoms, less likely to rely on other family planning methods, and more likely to first begin using the female condom in order to prevent pregnancy.

Among those who have used the female condom and the male condom, approximately 80 percent of men said they intend to use both methods in the future. However, a greater proportion of women said they will use the female condom again (68 percent), compared to the male condom (54 percent). But married women were less likely than single women to report continued use of either barrier method.

Potential added protection. STI/HIV protection may have increased among some users after the introduction of the female condom. For example, 27 percent of married women had never used a male condom before they used the female condom (27/98), and 20 percent of all consistent female condom users reported not being consistent male condom users prior to trying the female condom (13/65).

Continued male condom use. Ninety-four percent of inconsistent female condom users who were ever-users of the male condom reported that they continued to use the male condom after trying the female condom. Qualitative data revealed that female condom users often alternate the use of male and female condoms instead of relying on one method alone. Respondents said that what is used is determined by different factors, such as which method is available, what a partner wants to use, whether the woman is in her fertile period, and whether the woman is menstruating. Women also reported using female condoms when their husbands come home late at night or when they suspect infidelity. Additionally, some men reported using female condoms with their wives and regular partners while continuing to use male condoms with casual partners and sex workers.

	Print this page
@	E-mail this page

This page updated on
19 Oct 2007