From 2009-2014, the Washington, D.C. Female Condom initiative increased awareness, understanding, and use of the female condom, an underutilized HIV and STI prevention method. The female condom is similar to the male condom in both efficacy and reliability. It is the only self-initiated barrier method for women that prevents both unwanted pregnancy and STI transmission.
Funded by the M∙A∙C AIDS Fund, the Washington AIDS Partnership led this initiative, in collaboration with the D.C. Department of Heath’s HIV/AIDS, Hepatitis, STI, and TB Administration (HAHSTA); the Female Health Company; CVS/Pharmacy; and local community partners such as Calvary Healthcare, Metro TeenAIDS, Our Place, Planned Parenthood of Metropolitan Washington, and the Women’s Collective. Community partners provided in-depth education about and access to female condoms for women and their partners.
The initiative increased awareness and understanding of the female condom and its benefits, and about female anatomy. In the first three years of the initiative, community partners trained 1,273 female condom educators, distributed 567,250 female condoms, and conducted 1,456 group education sessions and 26,064 extended individual educational sessions.
In the final year of the initiative, community partners focused on direct education targeting women’s and youth health providers to ensure that female condoms are part of routine health care for women and young adults. Another focus was high-risk young adults who continue to be slow adopters of the female condom as a method of prevention. During the final year, 312 medical providers and 102 medical support staff were educated, and 7,757 youth participated in female condom trainings.
The Johns Hopkins Bloomberg School of Public Health conducted a cost-utility analysis of the first year of the Female Condom initiative. They found that enough HIV infections were prevented to save over $8 million in future medical care costs (over and above the cost of the program). The results of this study were published in the Journal of AIDS and Behavior.
Strategies for Incorporating Female Condoms into Health Promotion Programs
Unlike a male condom which can be distributed in any accessible public location, female condoms require a different approach. This initiative found that consumers need to be repeatedly exposed to female condoms before they are willing to use them.
In addition, the focus should not be just on women but also men. The initiative’s community partners found that men quickly accepted the female condom because it feels like they are having sex without protection. This was a surprising “lesson learned” that broadened the focus of this initiative to not just women but also their partners.
Agencies who would like to incorporate female condoms into HIV prevention interventions need to:
- Have staff who are well versed in the female anatomy, know how to correctly use a female condom, and understand the benefits of the female condom
- Educate both men and women about the female condom
- Incorporate role playing and negotiation skills into trainings so that participants can practice dispelling incorrect assumptions about the female condom
- Incorporate basic female anatomy information into all female condom trainings
- Normalize female condoms by having them readily available