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.

Weaknesses in primary health care favor the growth of acquired syphilis

Acquired syphilis is a sexually transmitted infection that affects the general population and has been growing in recent years in many countries. A study was developed aiming to analyze the trends of acquired syphilis associated with sociodemographic aspects and primary health care in Brazil, in the period from 2011 to 2019. This study used secondary data from the national notification systems of the 5570 Brazilian cities and a database of 37,350 primary health care teams, as well as socioeconomic and municipal demographic indicators. The trends of acquired syphilis at the municipal level were calculated from the log-linear regression, crossing them with variables of primary health care and sociodemographic indicators. Finally, a multiple model was built from logistic regression. 724,310 cases of acquired syphilis have been reported. In primary care units, 47.8% had partial coverage and 74.1% had health teams with poor or regular scores. 52.6% had rapid test for syphilis partially available. Male and female condoms are available in 85.9% and 62.9% respectively and 54.4% had penicillin available in the health facility. The increase in trends of acquired syphilis was associated with better availability of the rapid test; lower availability of male condoms; lower availability of female condoms; lower availability of benzathine penicillin; partial coverage of the teams in primary health care; limited application of penicillin in primary health care; higher proportion of teams classified as Poor/Regular in primary health care; higher proportion of women aged 10 to 17 years who had children; higher HDI; higher proportion of people aged 15 to 24 years who do not study, do not work and are vulnerable; and population size with more than 100,000 inhabitants. The following variables remained in the multiple model: not all primary health care teams apply penicillin; higher proportion of primary health care teams with poor/regular scores; population size >100000 inhabitants; partially available female condom. Thus, the weakness of primary health care linked to population size may have favored the growth of the acquired syphilis epidemic in Brazilian cities.

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.

Soft computing framework for modelling transmission dynamics of HIV/AIDS under combined use of male and female condoms in heterosexual populations of Taraba State

The widespread of HIV/AIDS has continued to constitute serious health and socioeconomic challenges for more than two decades, especially in sub-Saharan Africa. A permanent cure for this pandemic is not yet established and the issue of abstinence or faithfulness to sexual partners seems to be very difficult. This study used Genetic Agorithm of Soft Computing Framework for Modelling Transmission Dynamics of HIV/AIDS under combined use of male and female condoms in heterosexual populations of Taraba State. A total of 761 questionnaires were distributed to HIV/AIDS patients in the three senatorial zones of Taraba State. The researcher identified four set of terminals as independent variables: Never used condom, Used condom occasionally, Used condom most of the time, and Used condom all of the time. These values were converted to binary and coded as chromosomes into three fold: Male use of condom, Female use of condom, and Male and Female use of condom. The coded chromosomes of each category formed set of target values into the simulation of the Genetic algorithm. The simulation revealed that eradication of HIV/AIDS is obtainable in 6 generations with the use of male condom, 4 generations with the use of female condom and 2 generations with the use of both male and female condoms. The study also revealed that 56.4% of the respondents were female, 34.6% were male, 61.23% never used condom and 22.34% used condom all the times. This shows that there is no awareness on the use of female condom in Taraba State and probably the neighbouring states or Nigeria at large. The study recommended, among others, the use of both male and female condoms together as the best measure to achieve HIV/AIDS eradication in finite time.Keywords: Genetic Algorithm, HIV/AIDS transmission, Male and Female Condoms, Soft computing, Taraba StateVol. 26, No. 1, June 2019

Spanish validation of female condom attitude scale and female condom use in Colombian young women

Background Infection by HIV and other STIs and unplanned pregnancies are among the most serious problems associated with sexuality. Male and female condoms are the only dual-purpose devices to control both unplanned pregnancies and STIs, and studying people’s attitudes toward the use of these devices are excellent ways to predict their use. Therefore, the purpose of the present study was to adapt and validate the Female Condom Attitude Scale for Spanish language and to evaluate the use of female condoms in Colombian population. Methods For that purpose, a total of 387 Colombian women aged 23.68 years in average were asked to respond to the Female Condom Attitude Scale, the Sexual Opinion Survey, and the UCLA Multidimensional Condom Attitudes Scale. Results The use of female condom in Colombia is very low; only 5.10% of the surveyed women had used it at least once. On the other hand, results revealed a five-factor dimensionality (Sexual pleasure enhancement, Inconvenience, Improved prophylaxis, Sexual pleasure inhibition, and Insertion reluctance) with alphas between .81 and .96. The scale also showed adequate psychometric properties and criterion validity. No relationship was found between attitudes toward female condom and attitudes toward male condom. Conclusions The Spanish adaptation of the Female Condom Attitude Scale was found to be reliable and valid in a sample of young women.