This document outlines the introduction and promotion of the female condom in Southern Africa. It discusses the high HIV rates driven by factors like low condom use, multiple partnerships, and gender inequality. It then details how acceptability studies in Zimbabwe showed the female condom was viewed positively by sex workers and others for allowing female control and sensation. Advocacy efforts led to its registration in 1998 and social marketing campaigns. Lessons learned include the need for assertive women's training, engaging women's groups, and addressing gender and cultural norms to increase uptake for women's benefit.

1. Introduction of the
female condom in
Southern Africa
By
Caroline Maposhere
Gender, Sexual and Reproductive Health Consultant

2. Polyurethane

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

4. HIV in Southern Africa

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

16. Thank you