1999

The Female Condom in Zimbabwe:
The Interplay of Research, Advocacy, and Government Action

The Acceptability Study

In 1993, Drs. Sunanda Ray and Mary Bassett, two researchers from the University of Zimbabwe’s Department of Community Medicine and members of WASN, received funding from the World Health Organization (WHO) to conduct an acceptability study of the female condom in Zimbabwe. The researchers sought to determine whether the product was a viable alternative for Zimbabwean women, given that the device is not likely to be used without the consent of male partners.

The study (Ray et al. 1995) was conducted with three groups of women volunteers: sex workers, urban women attending a family planning clinic, and rural peasant women, all either married or in long-term relationships. Those who enrolled were interviewed at baseline and supplied with female and male condoms and trained in how to use them. Two follow-up interviews were conducted with participants, during which they received additional condoms. Workshops in both communication skills (how to introduce the female condom to a partner) and technical skills (how to use it correctly) took place during the course of the study. Participants also joined focus group discussions at the end of the second follow-up interview. Out of an initial enrollment of 221 women, 193 women remained at the first follow-up and 93 women at the second.

Findings from the first follow-up interview revealed that most of the women in all three groups and their male partners liked the female condom very much, in fact preferring it to the male condom. Less than 10 percent did not like the device. Other findings included the following:

• Because most of the women did not feel empowered to negotiate male condom use with their partners, the female condom offered a measure of control they hadn’t experienced before.
• Women felt better protected with female condoms because of their strength and resistance to breaking.
• Using the device became easier with practice, despite such complaints as difficulty of insertion and discomfort.

Participants were asked how their male partners felt about the female condom. Most men were reported to like the device, for these reasons:

• It could be inserted in advance of the sex act, with no interruption of intimacy.
• They did not have to have a full erection before intercourse.
• The device did not constrict the base of the penis, like male condoms.
• They did not have to withdraw from the vagina immediately after ejaculation.

Once the study was completed, the research team organized feedback sessions to discuss results with the NACP and other health officials, the Zimbabwe National Family Planning Council, WASN, AIDS research groups, and others. Major issues included the feasibility of offering the female condom as a mainstream method of prevention, given its prohibitively high cost of US$1.25 each, and the ethics of raising women’s expectations with no guarantee that the product would be available.

Participants at a female condom "roadshow." PSI conducts promotional tours throughout Zimbabwe to educate local residents about the device. Photo credit: Population Services International

The researchers argued that not just Zimbabwe but the entire developing world, where 90 percent of HIV infection occurs, must join with wealthier nations to seek ways to make new prevention methods affordable and accessible to all. Increasing worldwide demand for the product through such initiatives was also presented as one way of bringing costs down in the long term. As part of their dissemination activities, the team began to focus its efforts toward persuading local and international policymakers of the need to support the female condom, including lobbying UNAIDS for subsidies and pressing the NACP for action in response to the intense interest in the device.

	Print this page
@	E-mail this page

This page updated on
19 Oct 2007