Until recently, the male condom was the only contraceptive method that protected against sexually transmitted infections, including HIV infection. The development of the female condom--a female-controlled method offering this protection--has changed that.

The Reality female condom

Increased Use

Manufactured by the Female Health Company, the Reality female condom (marketed by different names worldwide) is a polyurethane sheath that, when inserted into the vagina, provides a protective barrier along the vaginal canal and over the external genitalia.

The female condom has recently seen widespread use in Sub-Saharan Africa, which has extremely high rates of HIV infection. The device has been proven very effective in protecting against sexually transmitted infections, including HIV.

Advantages Seen

In a 1997 worldwide review of the female condom by the World Health Organization, the device was found to be acceptable by many users. Some women even indicated a preference for the female condom over the male condom.

Many of the male partners in the study also liked the method. In Indonesia, male partners said women became aroused more easily and that it was cleaner to use than other contraceptive methods. In Costa Rica, most of the partners of sex workers studied said sex with the device felt "normal," which they liked.

A U.S. study indicated that the continuation rates of the female condom are comparable to other user-dependent methods. If used correctly every time, it has a 95% success rate.

Mixed Reactions

Despite its benefits, the female condom has met with mixed reactions. Some users object to the fact that it partially sits outside the vagina, while others complain that it "squeaks" during use, a problem that can be remedied by adding more lubricant.

Cost has been the largest barrier to the female condom's widespread use. In 1997, its manufacturer collaborated with the Joint United Nations Programme on HIV/AIDS to promote its use. One initiative reduced the unit price to under U.S.$1, prompting the governments of South Africa and Uganda to order a combined total of nearly 3 million since 1998.

Studies are being done to access the possibility of a reusable female condom, which could cut costs. Lower-cost variations of the device are under development by other companies worldwide.

Naadu Blankson-Seck is a writer and editor for AVSC.