With all the discussion about biomedical prevention strategies and the advances within the prevention paradigm, condoms are still recommended as an effective prevention method. Not only do they prevent the transmission of HIV but they are an effective barrier method for the prevention of other STIs and pregnancy. It is well known that if condoms are used properly and consistently they are an effective prevention tool.
The use of male condoms dates back several thousands of years and has developed over time in various forms to become the products which are available today. Male condoms are readily available and can be purchased cheaply from most stores and pharmacies and picked up for free from sexual health clinics and other community organisations and dispensing machines.
What about the lesser known female condom?
The female condom has been available in the USA since 1993 and became available in Australia soon after. Currently the female condom 2 (FC2) is being used and was developed from improvements to the original, FC1. It is said to now be used in over 100 countries around the world, however, few people know about female condoms in Australia, they are more expensive than the male condom and not as readily available. Female condoms have an incorrect reputation as being less effective, they have been widely discredited and likened to using a plastic bag. Evidence does show, however, when used correctly, the female condom can be up to 95% effective as a contraceptive method (Family Planning Queensland, 2012).
Female condoms were developed as a tool for women, to empower women to take control of their own protection. They can be used in situations where women find it difficult to negotiate the use of condoms with their male partners and can be inserted into the vagina several hours prior to sexual intercourse.
So what is a female condom and how do they work?
The female condom is a plastic sheath (made from polyurethane or nitrile) which is inserted into the vagina prior to sexual intercourse to provide a barrier which stops body fluids passing between sexual partners. It has an inner and outer ring which holds it in place during sex, with the outer ring extending outside of the body to provide even more protection against other STIs and can provide more stimulation for the woman.
Advantages
- Latex free
- Better option for men who cannot sustain erections whilst using male condoms
- Can be used with any kind of lubricant
- The material allows for heat transmission, making sex more enjoyable
- Can be inserted well before sex
Disadvantages
- Expensive
- Not readily available
- May take some practice to use correctly and effectively
Currently the FC2 is the only female condom approved for use in Australia, however, there are varying designs currently being trialled in other countries, and the “Woman’s Condom” is available in limited quantities in China and South Africa.
Internationally women and young girls are disproportionately affected by HIV, and in Australia we have seen an increase in heterosexual transmission of HIV in recent years.
Women need to be provided with options to make choices about prevention (of HIV and STIs) and to have access to simple barrier contraceptive methods, such as the female condom. If the acceptability of the current female condom is low, further research into barrier methods for women is needed in order to fine tune a design that is most acceptable as well as being more readily available and affordable for more universal uptake.
Why are male condoms funded by governments and so readily available and not female condoms? We need equity. If we wish to have a meaningful dialogue around shared responsibility of HIV and STI prevention, we need equitable access to barrier protection regardless of gender or gender identity. Free access to the various types of condoms will broaden our current prevention options and continue to provide women with a choice about what tools they want to use.
The 16th of September each year is Female Condom Day, an opportunity to raise awareness about female condoms and increase access. Female condoms can be found at QPP, some sexual health clinics and pharmacies or purchased online.
