The acceptability of the female condom: Perspectives of family planning providers in New York City, South Africa, and Nigeria
Rent the article at a discountRent now
* Final gross prices may vary according to local VAT.Get Access
This article seeks to fill the gap in female condom acceptability research by examining family planning (FP) providers' attitudes and experiences regarding the female condom in three countries (South Africa, the US, and Nigeria) to highlight providers' potential integral role in the introduction of the female condom. The case studies used data drawn from three independent projects, each of which was designed to study or to change FP providers' attitudes and practices in relation to the female condom. The case study for New York City used data from semistructured interviews with providers in one FP consortium in which no special female condom training had been undertaken. The data from South Africa were drawn from transcripts and observations of a female condom training program and from interviews conducted in preparation for the training. The Nigerian study used observations of client visits before and after providers were trained concerning the female condom. In New York City, providers were skeptical about the contraceptive efficacy of the female condom, with only 8 of 22 providers (36%) reporting they would recommend it as a primary contraceptive. In South Africa, providers who had practiced insertion of the female condom as part of their training expressed concern about its physical appearance and effects on sexual pleasure. However, they also saw the female condom as a tool to empower clients to increase their capacity for self-protection. Structured observations of providers' counseling interactions with clients following training indicated that Nigerian providers discussed the female condom with clients in 80% of the visits observed. Despite the lack of a uniform methodology, the three case studies illuminate various dimensions of FP providers' perceptions of the acceptability of the female condom. FP providers must be viewed as a critical factor in female condom acceptability, uptake, and continued use. Designing training programs and other interventions that address sources of provider resistance and enhance providers' skills in teaching female condom negotiation strategies may help to increase clients' use of the female condom.
- World Health Organization. The Female Condom: a Review. Publication number WHO/HRP/WOM/97.1. Geneva, Switzerland: World Health Organization; 1997.
- Cecil H, Perry MJ, Seal DW, Pinkerton SD. The female condom: what we have learned thus far. AIDS Behav. 1998;2:241–256. CrossRef
- Abdool Karim Q, Preston-Whyte E, Abdool Karim SS. Accessibility of condoms to teenagers at family planning clinics in Durban: part II: a provider's perspective. S Afr Med J. 1992;82:360–362.
- Simmons R, Hall P, Díaz J, Díaz M, Fajans P, Satia J. The strategic approach to contraceptive introduction. Stud Fam Plann. 1997;28:79–94. CrossRef
- Kim YM, Maranguanda C, Kols A. Quality of counseling of young clients in Zimbabwe. E Afr Med J. 1997;74:4–5.
- Harrison PF, Rosenfield A., eds. Contraceptive Research, Introduction, and Use. Lessons from Norplant. Institute of Medicine Sub committee for Workshop in Implant Contraceptives: an Illuminating Case Study in Current Dilemmas and Possibilities. Washington, DC: National Academy Press; 1998.
- Mfono Z. Teenage contraceptive needs in urban South Africa: a case study. Int Fam Plann Perspect. 1998;24:180–183. CrossRef
- World Health Organization. Reproductive health research: the new directions. Biennial Report 1996–1997. In: Khanna J, Van Look PFA, eds. Geneva, Switzerland: World Health Organization; 1998.
- Brown JW, Boulton ML. Provider attitudes toward dispensing emergency contraception in Michigan's title X programs. Fam Plann Perspect. 1999;31(1):39–43. CrossRef
- Sharma V, Sharma A. Condom promotion strategies: what we need to know? [letter]. AIDS. 1995;9:537–538.
- Speizer IS, Hotchkiss DR, Magani RJ, Hubbard B, Nelson K. Do service providers in Tanzania unnecessarily restrict clients' access to contraceptive methods? Int Fam Plann Perspect. 2000;26:13–20, 42. CrossRef
- Feldblum P, Kuyoh MA, Bwayo JJ, et al. Female condom introduction and sexually transmitted infection prevalence: results of a community intervention trial in Kenya. AIDS. 2001;15:1037–1044. CrossRef
- Kerrigan D, Mobley S, Rutenberg N, Fisher A, Weiss E. The Female Condom: Dynamics of Use in Urban Zimbabwe. New York, NY: The Population Council Horizons; October 2000.
- New York City Department of Health, Office of AIDS Surveillance. AIDS Surveillance Update in NYC First Quarter. New York, NY: New York City Department of Health; 2000.
- South Africa Department of Health, HSR and Epidemiology Directorate. National HIV survey of women attending antenatal clinics of the public services in South Africa, 2001.
- Joint United Nations Programme on HIV/AIDS. AIDS Epidemic Update: December 2000. Geneva, Switzerland: Joint United Nations Programme on HIV/AIDS. December 2000.
- Orubulaye IO, Caldwell JC, Caldwell P. Perceived male sexual needs and male sexual behavior in Southwest Nigeria. In: Caldwell JC, Caldwell P, Orubuloye IO, et al., eds. Toward the Containment of the AIDS Epidemic: Social and Behavioural Research. Canberra, Australia: Health Transition Centre; 2000:1–19.
- Messersmith LJ, Kane TT, Odebiyi AI, Adewuyi AA. Who's at risk: men's STD experience and condom use in Southwest Nigeria. Stud Fam Plann. 2000;31(3):203–216. CrossRef
- Nigeria Population Commission. Nigeria Demographic and Health Survey 1999. Calverton, MD. National Population Commission and ORC/Macro; 2000.
- Mantell JE, Scheepers E, Abdool Karim QA. Introducing the female condom through the public health sector: experiences from South Africa. AIDS Care. 2000;12:589–601. CrossRef
- Becker J, Leitman E, Fathalla MF. Introducing sexuality within family planning: the experience of three HIV/STD prevention projects from Latin America and the Caribbean. Quality/Calidad/Qualite. No. 8. New York, NY: Population Council; 1997.
- Stein Z. Editorial: Family planning, sexually transmitted diseases, and the prevention of AIDS—divided we fail? Am J Public Health. 1996;86(6):783–784. CrossRef
- The acceptability of the female condom: Perspectives of family planning providers in New York City, South Africa, and Nigeria
Journal of Urban Health
Volume 78, Issue 4 , pp 658-668
- Cover Date
- Print ISSN
- Online ISSN
- Additional Links
- Dual protection
- Family planning
- Female condom
- Health care providers
- HIV/AIDS and STD prevention
- Author Affiliations
- 1. HIV Center for Clinical and Behavioral Studies, New York State Psychiatric Institute/Columbia University, 1051 Riverside Drive, Unit 15, 10032, New York, NY
- 2. Association for Reproductive and Family Health, Ibadan, Oyo State, Nigeria
- 3. Joseph Mailman School of Public Health, Columbia University, Division of Epidemiology, New York, New York
- 4. the Department of Public Works, Community Development Programme, Pretoria, South Africa
- 5. the Community Health Care Network, New York, New York
- 6. the International Center for Research on Women and Horizons, Washington, DC