Introduction
Uganda Female Condom Coalition (UFCC) is a policy advocacy coalition
comprised of twenty organizations working on reproductive health and HIV and
AIDS that are committed to the promotion of the use of the Female Condom as an
alternative means of family planning and prevention of STIs/HIV and AIDS. The
Coalition was galvanized into formation after the training on ‘Female Condom Advocacy’ training organised
by Centre for Health and Gender Equity (CHANGE) and Global Campaign for Microbicides in
June 2009.
In
Uganda women make up more than half of the 1.3 million people currently
infected with HIV. The consequences of unprotected sex and the huge burden of
unplanned pregnancy and risk of infection are primarily faced by women. This
situation calls for a response that effectively addresses the exceptional
vulnerability of women moreover HIV/AIDs infection patterns have shifted
from single/casual to long-term stable relationships. Uganda’s 2005 sero-survey
suggests that up to 65% of new HIV infections are occurring among married
people making it
necessary for new strategies to be adopted and the female condom is one such
strategy.
The facts speak for themselves about
the acceptability of the female condom, its effectiveness and the action that has
to be undertaken. Female condoms exist now; the push for universal access to
them should begin.
Why the Female Condom should be Accessible?
251 million women in developing countries would like to use the
female condom but have no access to it.
·
The female condom offers women
and men dual protection
· The female condom protects sexually transmitted infections including HIV and prevents
pregnancy.
· The female condom contributes to meeting international
commitments on development.
· The Millennium Development Goals
(MDG’s) on maternal and child mortality and morbidity rates, as well as HIV/AIDS will not be attained if existing
technologies, such as the female condom, remain out of the reach of women who
need this condom.
· Gender inequality is an
important driver of the HIV epidemic, the feminisation of AIDS has become a
reality. Women
make up more than half of the 1.2 million people currently infected with HIV in
Uganda. In
sub-Saharan Africa 76% of HIV-positive youth are female. Women and girls face
the consequences of unprotected sex and bare a huge burden of unwanted
pregnancy and risk of infection. The female condom is the only device that
offers dual protection, is women-initiated and is available now. Universal
access to female condoms should therefore be a priority.
The Availability of Female Condoms in Uganda
• From 1993 to 2005 the only female condom was the Female
Health Company FC.
• FC1 is now being replaced by FC2, those are the only two
female condoms with WHO pre qualification
• Dr. Reddy female condom has not yet fulfilled all the
requirements of the WHO pre-qualification procedure. It is approved for use
throughout Europe and many other countries and around five million were sold
commercially between 2003 and 2007.
• The PATH woman’s condom is under development and is seeking
funding for trails to gain approval.
• Only 0.24 per cent of all condoms produced are
female-condoms.
What is hindering the Demand/Uptake of the Female Condom?
• Failure to promote and increase the production
of female-condoms is due to: ignorance, culture, denial, “poverty” and
conservatism:
• Ignorance causes poorly informed decision makers to rely on
media stereotypes regarding female condoms rather than scientific studies.
• Culture creates a sometimes explicit
bias to female condoms; the personal beliefs and values of a few individuals
often prevail over evidence informed policy guidance.
• Denial allows sceptics to argue that the female-condom is
just an expensive condom that still requires negotiation. Moreover, it permits
ignorance towards the men who don’t like to use male condoms, and prefer
female-condoms.
• “Poverty” and the claim that female-condoms are not
affordable are the most publically acceptable reasons for failing to make female-condoms
accessible
Benefits of the Female Condom
• Qualitative
studies find an increased sense of power for negotiation of safer sex, and a
greater sense of control and safety during sex, among women using
female-condoms.
• Effective female-condom programming also enables women, men
and health professionals to gain a better understanding of women’s bodies and a
greater ability to discuss sexuality and safer sex.
• Female-condoms have the advantage of no side effects, are
reversible forms of contraception, and can be used without seeking a
health-care provider.
• Female-condoms offer more flexibility regarding the timing
of putting them on (up to 8 hours before the sexual act) and taking them off.
• Synthetic female-condoms have a soft, moist texture which
feels more natural during sex. For men the sensation is closer to that of sex
without a condom, because female condoms do not fit tightly around the penis as
male condoms do.
• Unlike latex condoms, synthetic female condoms are not
damaged by oil based lubricants nor affected by changes in temperature and
humidity, so they can be safely stored almost anywhere.
Recommendations for Change:
• Reduce the price of female-condoms. This can achieved by
creating demand, investing in new designs, encouraging the not-for profit
production of female-condoms, and allowing generic versions of female-condoms
to be produced.
• Create visible global leadership through the collaboration
of UNAIDS, UNFPA, and donor and development organizations. Use this global
leadership to promote female-condoms as a contraceptive and a prevention method
against STIs including HIV. Moreover, work to raise the female-condom
distribution rate and lower the cost.
• Incorporate the female-condom within the gender and health
policies of UN agencies and international donors. Incorporation of such
would significantly boost investment.
• Support female-condom research and development. Variety is
needed because it is not one size fits all. Moreover a new female condom is
needed to increase demand and will reduce the price.
• Create comprehensive long-term integrated female-condom
programming. National governments, civil society organizations, and the private
sector should collaborate to create programming and thus work to make female
condoms available to all women and men.
