Women reusing female condom, despite risks

The high cost of the female condom is forcing Zimbabwean women, particularly commercial sex workers, to reuse the device to save money, despite the risks associated with reuse, AIDS activists have warned. Recent workshops between the Women's AIDS Support Network (WASN) and commercial sex workers have revealed that many of the women were reusing the condom after cleaning it with substances such as beer, urine, water and detergents. "They said they were doing this because they couldn't afford to buy it," WASN information officer Matilda Moyo, told PlusNews. Unlike the male condom, the female condom remains beyong the budget of most Zimbabweans, and can cost up to Z$ 55 (US$ 1). "The male condom is freely available and you can buy a pack of 3 for as little as Z$ 5 [US $0.09] or even for free. The female condom is mostly available at pharmacies, not in supermarkets or tuck shops. On the other hand, you can get the male condom anywhere, even in a public library. These discrepancies need to be addressed," Moyo said. Despite a high level of awareness of HIV/AIDS, most of the sex workers were not aware of the risks of reusing the device. "As long as they are using something, as far as they are concerned they are safe," she added. There was a need for an information campaign on the female condom in Zimbabwe. "There is still a lack of information on how to handle the condom and on the danger of reusing it," Moyo said. "When it first came to Zimbabwe it was subsidised and well advertised. There was a media blitz and everyone was excited about it, but [since then] there has been no follow-up and everything has just died," she added. The country's humanitarian and economic crisis had "disempowered" women, as they were the worst affected. Female condoms were now a luxury item they could no longer afford. Women's Action Group (WAG) director, Edinah Masiyiwa, called for the cost of the female condom to be subsidised. "Why should we even debate about reuse? The government should subsidise it because it is unrealistic to expect people to afford it now," she told PlusNews. Reuse of female condoms has been a hotly debated issue for the last two years. Large international organisations have been reluctant to approve reuse although it is well known that it is a common practice, especially among sex-workers. Responding to requests for guidelines on the safety of reuse, the World Health Organisation (WHO) and UNAIDS convened "consultations" in June 2000 and July 2002. "WHO does not recommend or promote reuse of female condoms. Recognising the urgent need for risk-reduction strategies for women who cannot or do not access new condoms, the consultation developed a draft protocol for safe handling and preparation of female condoms intended for reuse. "The protocol is based on the best available evidence, but has not been extensively studied for safety and has not been evaluated for efficacy in human use," a WHO statement said. Given the diversity of "cultural and social contexts and personal circumstances", the consultations agreed that the final decision on whether to support reuse of the female condom would need to be taken locally.