3. Presentation outline
Background – HIV epidemic in Southern Africa
The Zimbabwe story
Introduction at ICASA IN 1995
Acceptability studies
Advocacy for registration
Social marketing
Advocacy for availability
Lessons learnt
5. HIV Epidemic in Southern
Africa
• Factors that fuel the epidemic
Low or no condom use
Large number of infected people not on treatment
Multiple concurrent partnerships
Underlying factors that fuel the spread of HIV in the region?
gender inequality
poverty
cultural and religious beliefs
legal and policy environment
6. Story of Zimbabwe
WHO consignment to the University of Zimbabwe –
Department of Community Medicine
Female condom discussion at ICASA – 1995
Introduction of the condom
Presentation room full – people were curious
Insertion demonstration
7. Acceptability studies
Urban studies –
Sex workers
Taxi drivers
Rural studies
Married women
8. Acceptability studies
cont…..
Added advantages of the female condom
Female initiated and controlled
Stronger
More natural feel
Excitation from the rings
Timing of insertion and removal
9. Advocacy for registration
Dissemination of acceptability study findings
Women and AIDS Support Network
Collection of signatures
Lobby Female Deputy Minister of health
Registration of the female condom - 1998
10. Social Marketing
PSI – Care Contraceptive Sheath
Interpersonal communication approach
– hair salons, community peer educators
11. Advocacy for availability
Female condom strategy
As part of national HIV prevention strategy as well as
dual protection aspect
All condom distribution discussions include male and
female condoms
Intensive training sessions for service providers at all
levels
12. Availability – re use
WHO guidelines
Soaking the condom in a 1:20 solution of household
bleach for between two and five minutes
Washing the condom in soap and water to remove all
traces of bleach, lubricant and ejaculate.
Air-drying the condom, turning it inside out to ensure
both sides are dry.
Re-lubricating, preferably with silicone or water-based
lubricants, though with the polyurethane
condom alone oil-based ones such as petroleum jelly,
baby oil, and vegetable oil or fat.
Condoms should be reused no more than five times
13. Lessons learnt
Linked research and advocacy to strengthen
political movement with evidence - Integrate into
health care system as evidence based programming
and train service providers as part of Sexual and
Reproductive Health
The barriers that exist for male condom use, also
exist for the female condom
14. Lessons learnt cont….
Need for accompanying assertive training for
women and girls to increase uptake for their benefit
– not just as a public health agenda but a gender
issue
Gender issue – hence engage pressure groups that
are working on women empowerment issues
15. Lessons leant cont….
Use the changing the rivers flow model
Using community dialogues, interrogate sexual norms
and see where safety, satisfaction and negotiation fit
in patriarchal societies
modify existing and deep rooted cultural practices
male involvement for the benefit of women and girls i.e.
men as protectors