Women in Africa have been the hardest hit by HIV/AIDS. Twenty years into the pandemic, very little has been done to empower them to insist on safe sex.
However, a growing interest in the female condom could correct this imbalance.
The introduction of the female condom, particularly in countries where HIV/AIDS is rampant, has become a major talking point. Several debates about this relatively new form of contraception were held at the recent 12th International Conference on AIDS and STDs in Africa (ICASA), held in Burkina Faso.
Many HIV/AIDS advocacy groups saw the female condom as a significant new alternative that women can use to better protect themselves against infection. Concerns were raised, however, about the poor education campaigns and prohibitive cost of the device.
In South Africa, television advertisements for the female condom are screened regularly and it will now be offered to South African women free of charge. It previously retailed at around US $0.50 for a box of two.
The Planned Parenthood Association of South Africa, the Reproductive Health Research Unit, the Society of Family Health and the Department of Health will supply the female condom. According to the Female Health Company - which produces the female condom - South Africa receives three million of the eight million female condoms distributed around the world each year.
But speaking at a reception at ICASA held by the Global Campaign for Prevention Options for Women - an initiative to increase access to female-controlled HIV/STI prevention methods - Mitchell Warren, vice-president of the Female Health Company, admitted that there was a still a long way to go before the female condom became universally accepted.
During several sessions at the ICASA, it became apparent that the female condom was still a mystery for many of the delegates. "This thing looks too funny, I'm not sure how it will work," one Tanzanian delegate told PlusNews.
A study conducted on the use of the female condom by female sex workers in Abidjan, Cote d'Ivoire, found that social marketing of the condom didn't exist. A clinic which supplied the female condom to sex workers reported poor sales despite positive feedback from the female sex workers.
Many sex workers were enthusiastic about the independence the female condom gave them. They reported that they could use the condom without their clients' knowledge. However, the sex workers said they were too expensive and they would not use it regularly.
The high cost of the female condom has made it inaccessible to most women on the continent. Dr Eddie Mhlanga, Chief Director of Maternal Child and Women's Health and Nutrition in South Africa, remarked that price was not the only barrier. He added that more needed to be done to sensitise women and popularise the product.
If the female condom can be used safely more than once, the cost of each use would decline. Studies have found that the device remains structurally sound after repeated washings and re-use.
There was confusion at the ICASA about whether this was acceptable for female sex workers. While it was acceptable for couples to re-use the female condom, researchers working with female sex workers in Abidjan said it was not advisable to re-use it if you were having sex with different partners.