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FHI Research Briefs on the Female Condom — No. 1:Dialogue on the Female Condom: An Overview on Science and Advocacy |
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The female condom is intended to serve a dual role, providing protection from pregnancy and sexually transmitted infection (STI). It offers a potential alternative to the male condom, and women may have more control over negotiating use of the female condom than the male condom. In the past 15 years, research on the female condom and efforts to introduce this new device to various populations have increased markedly. From small pilot trials that led to modifications in the device itself, research efforts expanded to introduction and effectiveness studies. Female condoms are available in at least 40 countries; however, only a handful of those countries have established, well-documented promotion and distribution programs.
However, some researchers and policy-makers are more cautious about committing to wide-scale introduction of the method. Concerns include whether the device is too expensive, can be used safely more than once (thus lowering the cost), will replace rather than complement male condom use, will be accepted beyond an initial novelty interest, and is effective in typical use. What is the appropriate role for the female condom in reproductive health programs? To help facilitate a fruitful dialogue on this question among researchers, policy-makers, program planners and women's health advocacy groups, Family Health International produced a series of research briefs synthesizing available research on some of the most important scientific and policy questions. The research briefs currently available in this series are:
The U.S. Food and Drug Administration approved the first type of female condom in 1993 for one-time use for prevention of pregnancy. Called by various names around the world, it is made of polyurethane plastic, which is sturdier than latex. It is a soft, loose-fitting sheath with a flexible polyurethane ring at each end. The woman inserts it into her vagina, with the inner ring anchoring the device. The outer ring remains outside the vagina, providing some protection to the labia and the base of the penis during intercourse. Fitting by a health professional is not required, as the device does not have to fit precisely over the cervix. Only one size is made. Unlike latex male condoms, which are weakened by using oil-based lubricants, the female condom may be used with any type of lubricant without compromising its strength. It is pre-lubricated, but users may add more lubricant. UNAIDS has negotiated a public-sector price of U.S. $0.57 per condom with the Female Health Company, the manufacturer of this female condom. The unit price of a male condom is about U.S. $0.05. Unsubsidized, the female condom currently sells for about U.S. $2-$3. If the device can be used more than once, the effective cost will decline (see Female Condom Research Brief Number 3). A second-generation female condom, known as FC2, is expected to cost less than the original female condom because it is made of a different material (nitrile, a latex derivative) that makes it less expensive to produce. In August 2006, the World Health Organization completed a technical review of the FC2 and approved it for bulk purchases by United Nations agencies. FHI produced these research briefs as part of an information dissemination effort supported by the Bureau for Africa/Office of Sustainable Development, U.S. Agency for International Development. |
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Many women's advocacy groups see the female condom as a significant alternative that women can use to reduce their risk of acquiring STIs, including HIV. Some important policy-makers have offered major support of the method. Peter Piot, executive director of the Joint United Nations Programme on HIV/AIDS, says, "The female condom needs more financial and program support from donors, nongovernmental organizations and the international community, to ensure that women who would benefit most have access to it."