Examining the place of the Female Condom in India’s Family Planning Program: A qualitative investigation of the attitudes and opinions of key stakeholders in Pune, India

Background: With overpopulation contributing to the depletion of planetary resources, the high rates of unintended pregnancies in India are a cause for concern. Despite the free supply of contraception options within India’s national family planning initiatives, women are generally offered hormonal options as temporary spacing methods. However, female condoms, a much neglected but potent women initiated, non-hormonal multipurpose prevention device, are yet to be considered for inclusion in India’s contraceptive cafeteria. Thus, we aim to examine the place of female condoms among the contraceptive options, by analysing the perceptions of key stakeholders regarding its advantages and disadvantages, along with their opinions on how female condoms should be promoted.Methods: We used purposive sampling to recruit and interview potential users and dispensers of the female condom. The interview participants visited or worked at family planning clinics in Pune at Smt. Kashibai Navale Medical College and General Hospital (SKNMC-GH), its urban and rural outreach clinics, and at Saheli (a non-governmental organisation for female sex workers). We conducted semi-structured interviews and coded our data inductively. Results: We interviewed 5 rural women, 20 urban women (including 10 female sex workers), 5 male partners of female sex workers, and 5 family planning healthcare providers. Nearly half (12/25) of the women we interviewed, said that they were eager to use female condoms in the future. Many participants perceived female condoms to be an instrument to empower women to be in control of their sexual and reproductive lives (15/35), and that it provided user comfort and confidence (4/35). Their perceived disadvantages are that they are relatively more expensive (6/35), users have limited experience (9/35), and women who buy or use them may be stigmatised and feel embarrassed (4/35). Yet, nearly three-quarters of potential users (21/30) and most healthcare providers (4/5), were confident that female condoms could become popular following extensive promotional campaigns, interventions to improve availability and access, and initiatives to enhance the knowledge of female users. Conclusions: Female condoms have garnered support from both users and dispensers and have the potential to be widely adopted in India if family planning initiatives which increase awareness, knowledge, and access are systematically undertaken as with other contraceptive options.

Systematic review and meta-analysis assessing the knowledge and use of the female condom among Nigerians

Background: The female condom (FC) is a critical component in a comprehensive and sustainable approach to prevent HIV, other sexually transmitted infections and unintended pregnancies. Objectives: This review provides comprehensive information about Nigerian’s knowledge and use of FC. Methods: We screened search output, evaluated study eligibility, and extracted data in duplicate. Data from similar studies were combined in a meta-analysis. Results: There was a significantly (p < 0.0001) high-level of awareness amongst the respondents. However, the use of the FC was very low at 5.5% among female respondents. There was a significant (p < 0.0001) difference between FC awareness and use. The main reasons for FC use were prevention of unintended pregnancy (55%) and STIs/HIV (31%). We observed a significant difference between reasons of non-use of the FC [F (5, 13) = 5.195, P = 0.0077]. Furthermore, there were significant differences between the sources of information on FC [F (3, 8) = 32.89, P < 0.0001]. Conclusion: Despite the high levels of awareness, especially among the female respondents, the use of the FC has remained extremely low even among the young, educated undergraduate students. There is aneed for robust and consistent advocacy to make the FC available and affordable. Keywords: Female condom; women; men; awareness; use; Nigeria.

Assessing attitudes and high-risk practices to HIV/AIDS infection among the people of Lake Chad basin, Borno State, Nigeria

A cross sectional quantitative survey that obtained information on high risk behaviours which expose individuals to sexually transmitted infections (STIs) especially HIV was carried out in Lake Chad Basin of Borno among 1,790 volunteers. A well-structured questionnaire was developed and used to collect the desired baseline sociodemographic characteristics by direct interview of respondents in their houses among the populations living in the ordinary households, the mobile population and vulnerable population group (VPG) not living in the households were interviewed in their places of abode with discretion. The mean age range of the participants was 32.5 years (SD + 2.21) ranging from 15 to 49 years. 1,234 (68.9%) of the respondents were males while 556 (31.1%) were females. The prison inmates had the highest prevalence of STIs, 37% of the respondents didn’t know that they were at risk of contracting HIV. The knowledge of HIV status was higher among the males (80.2%) than the females (19.3%). The use of male and female condom was higher among the rural (19.2%) than the urban (10.8%) respondents. This study revealed high risk practices among the respondents even though there is tremendous HIV test intake across both the general and vulnerable populations, there is need for more awareness as rate of risk perception is very low.

Views and experiences of the female condom in Australia: An exploratory cross-sectional survey of cisgender women

Background The female condom is the only female-initiated form of protection against unintended pregnancy and sexually transmissible infections (STIs). However, use of this method in Australia is low. To better understand women’s views and experiences of the female condom, we conducted an interventional cross-sectional study. Methods Cisgender women ≥16 years, heterosexually active and living in New South Wales were recruited through social media advertisements and email invitations to clients of a family planning service. Eligible participants were provided with three female condoms and invited to complete a follow-up survey. Survey responses for women who attempted to use at least one female condom were summarised using counts and proportions. Results We recruited 556 women; few (30/556) had used the female condom before the study. There were 284 women who used, or attempted to use, a female condom during the study and completed the follow-up survey. Fifty-one percent (104/205) reported experiencing some difficulty in insertion, although only 46% (130/284) had seen an instructional demonstration. Approximately half (105/204) of women rated the sensation and comfort of the female condom as the same or better than the male condom, and 66% (137/204) reported that it provided the same or better lubrication. Approximately half of women said they would consider using the female condom again for STI prevention (51% (133/260)) or contraception (40% (103/260)), or would recommend to others (43% (112/260)). Conclusion Findings highlight the need for increased health promotion and education regarding use of the female condom. To increase access it will be important to address method cost and availability in Australia. Future research should explore other perspectives of this method, including among the LGBTIQ+ community.

KNOWLEDGE ABOUT HIV AND SOURCE OF CONDOMS AMONG YOUTH IN STATES AND UNION TERRITORIES OF INDIA

Background: Only 37.3% of the participants had a high knowledge score. Most participants knew the main routes of HIV transmission; however, misconceptions existed about the transmission of HIV through mosquito bites across all age groups (31.7% correct response). According to National Aids Control Organization, India HIV Estimation 2017 report, National adult (15–49 years) HIV prevalence in India was estimated 0.22% (0.16% – 0.30%) in 2017. In the same year adult HIV prevalence reported was 0.25% (0.18-0.34) among males and at 0.19% (0.14-0.25) among Females(1). Condoms or sheaths are the oldest forms of barrier contraception used by the male(2). The female condom is made up of prelubricated polyurethane sheath which covers introitus in toto. It is found effective as a contraceptive as well as found protective against HIV/STI with the efcacy of 95% with perfect use and 79% with typical use(3). Methodology: In present study data is taken from National Family Health Survey-4(NFHS-4), 2015-16.The literature was reviewed using PubMed as well as Google search engine. The data was analyzed for states as well as union territories. The references quoted in this study were relevant with the title of the study e.g. relevant with knowledge about HIV and source of condoms. Results: Results were represented under to heads bibliography of women and bibliography of men thereafter a brief explanation of results was made beneath the subtitles, misconception and prevention, comprehensive knowledge of HIV and knowledge of condom source. Discussion: On the basis of this study, women and men who rejected two common misconceptions and knew how to prevent HIV/AIDS were reported 51.6% and 63% respectively. Whereas comprehensive knowledge of HIV in women is found less than 50% whereas in men it is observed not more than 59%, knowledge of condom source was found lesser in women (67.6%) than men (95.1%).Under all the three descriptions men are leading women. Condom awareness should be promoted at paramount class, especially in women cadre. Sex education may furnish with some high-yielding consequences.

Using human-centred design to develop an innovative female condom

ObjectiveThe female condom is a non-hormonal barrier method that can protect from unintended pregnancy and sexually transmitted infections such as HIV. Female condoms are an important contribution to women’s reproductive health globally as they are the only woman-initiated method currently available that can provide dual protection. This article describes how human-centred design (HCD) was applied to the development of the Woman’s Condom—a second-generation female condom.MethodsA multidisciplinary team pioneered the application of HCD principles to develop a novel reproductive health product. The Woman’s Condom design incorporated feedback from both female and male users from multiple sites in the USA and Cuernavaca, Mexico; Durban, South Africa and Khon Kaen, Thailand to inform product development.ResultsWe developed and tested more than 50 design iterations reflecting various solutions to user-related concerns. The final locked design confirmed that the Woman’s Condom was easy to use, stable, comfortable and provided satisfactory sensation during sex for both partners. The ‘dissolving capsule’ to facilitate insertion and ‘soft cling’ design are key innovative features of the Woman’s Condom.ConclusionThe Woman’s Condom is a second-generation female (or internal) condom product that has been shown to be highly acceptable to users throughout the world. The Woman’s Condom’s special design features enable easy insertion, secure fit during use, good sensation and easy removal. Engaging users as codesigners through an HCD approach resulted in a female condom that meets the needs of women and men from diverse regions.

Uso e negociação de preservativos por acadêmicos de enfermagem

Identificar o uso e a negociação do preservativo por acadêmicos de enfermagem e discutir as práticas sexuais destes estudantes na perspectiva da prevenção das infecções sexualmente transmissíveis. Descritivo, transversal com abordagem quantitativa, realizado com 153 estudantes de enfermagem de uma instituição privada. Foi empregado um questionário estruturado com 60 perguntas fechadas. Para a análise, utilizou-se a estatística descritiva com o auxílio do Excel for Windows. Foram atendidos todos os aspectos ético-legais. 91% participantes tinham vida sexual ativa. Destes: 72% não faziam uso do preservativo em todos os intercursos sexuais; 59% não usavam com parceria fixa; 76% utilizavam-no nas parcerias sexuais casuais e 90) informaram não usar preservativo feminino. A negociação do uso era realizada por 32 dos participantes. Evidenciou-se uma baixa adesão para o uso contínuo de preservativo, o que, juntamente com as situações de negociações de seu uso, favoreceu a exposição às infecções sexualmente transmissíveis.Descritores: Negociação, Preservativos, Comportamento Sexual, Infecções Sexualmente Transmissíveis. Use and negotiation of condoms by nursing academicsAbstract: To identify the use and negotiation of condoms by nursing students and discuss the sexual practices of these students with a view to preventing sexually transmitted infections. Descriptive, cross-sectional with a quantitative approach, carried out with 153 nursing students from a private institution. A structured questionnaire with 60 closed questions was used. For the analysis, descriptive statistics was used with the aid of Excel for Windows. All ethical and legal aspects were met. 91% participants had an active sex life. Of these: 72% did not use condoms in all sexual intercourse; 59% did not use with a fixed partnership; 76% used it in casual sexual partnerships and 90% reported not using female condom. Use negotiation was carried out by 32 of the participants. There was a low adherence to the continued use of condoms, which, together with situations of negotiation of their use, favored exposure to sexually transmitted infections.Descriptors: Negotiating, Condoms, Sexual Behavior, Sexually Transmitted Diseases. Uso y negociación de condones por los académicos de enfermeríaResumen: Identificar el uso y la negociación de condones por parte de académicos de enfermería y discutir las prácticas sexuales de estos estudiantes con miras a prevenir las infecciones de transmisión sexual. Descriptivo, transversal con enfoque cuantitativo, realizado con 153 estudiantes de enfermería de una institución privada. Se utilizó un cuestionario estructurado con 60 preguntas cerradas. Para el análisis, se utilizó estadística descriptiva con la ayuda de Excel para Windows. Se cumplieron todos los aspectos éticos y legales. El 91% de los participantes tenían una vida sexual activa. De estos: 72% no usaban condones en todas las relaciones sexuales; El 59% no lo usó con una sociedad fija; ell 76% lo usó en parejas sexuales casuales y 90) informaron que no usaban condón femenino. La negociación de uso fue realizada por 32 de los participantes. Hubo una baja adherencia al uso continuado de condones, lo que, junto con situaciones de negociación de su uso, favoreció la exposición a infecciones de transmisión sexual.Descriotores: Negociación, Condones, Conducta Sexual, Enfermedades de Transmisión Sexual.

Diverging trends in US male-female condom use by STI risk factors: a nationally representative study

ObjectiveCondom use behaviours are proximal to recent STI increases in the USA, yet it remains unclear whether the use of condoms has changed over time among unmarried, non-cohabiting young men who have sex with women (MSW) and how this variability is influenced by STI risk factors.MethodsTo examine condom use over time among MSW aged 15–29, we used three cross-sectional surveys from the 2002, 2006–2010 and 2011–2017 National Survey of Family Growth. We estimated weighted percentages, adjusted prevalence ratios (APRs) and 95% confidence intervals (CI) to assess changes in condom use, stratified by whether MSW reported any STI risk factors in the past 12 months (ie, perceived partner non-monogamy, male-to-male sex, sex in exchange for money or drugs, sex partner who injects illicit drugs, or an HIV-positive sex partner).ResultsWe observed a divergence in trends in condom use at last sex between men aged 15 –29 with STI risk factors in the past 12 months and those without such history. We saw significant declines in condom use from 2002 to 2011–2017 among men with STI risk factors (APR=0.80, 95% CI 0.68 to 0.95), specifically among those aged 15–19 (APR=0.73, 95% CI 0.57 to 0.94) or non-Hispanic white (APR=0.71, 95% CI 0.54 to 0.93). In contrast, trends in condom use among men with no STI factors remained stable or increased. Across all time periods, the most prevalent STI risk factor reported was perception of a non-monogamous female partner (23.0%–26.9%). Post-hoc analyses examined whether condom use trends changed once this variable was removed from analyses, but no different patterns were observed.ConclusionsWhile STIs have been increasing, men aged 15–29 with STI risk factors reported a decline in condom use. Rising STI rates may be sensitive to behavioural shifts in condom use among young MSW with STI risk factors.