Journal of Urban Health

, Volume 78, Issue 4, pp 658–668

The acceptability of the female condom: Perspectives of family planning providers in New York City, South Africa, and Nigeria

Authors

    • HIV Center for Clinical and Behavioral StudiesNew York State Psychiatric Institute/Columbia University
  • Susie Hoffman
    • HIV Center for Clinical and Behavioral StudiesNew York State Psychiatric Institute/Columbia University
  • Eugene Weiss
    • Association for Reproductive and Family Health
  • Lawrence Adeokun
    • Association for Reproductive and Family Health
  • Grace Delano
    • Association for Reproductive and Family Health
  • Temple Jagha
    • Association for Reproductive and Family Health
  • Theresa M. Exner
    • HIV Center for Clinical and Behavioral StudiesNew York State Psychiatric Institute/Columbia University
  • Zena A. Stein
    • HIV Center for Clinical and Behavioral StudiesNew York State Psychiatric Institute/Columbia University
  • Quarraisha Abdool Karim
    • Joseph Mailman School of Public HealthColumbia University, Division of Epidemiology
  • Elma Scheepers
    • the Department of Public WorksCommunity Development Programme
  • Kim Atkins
    • the Community Health Care Network
  • Ellen Weiss
    • the International Center for Research on Women and Horizons
Special Feature: Female-Initiated Methods of STI/HIV Prevention

DOI: 10.1093/jurban/78.4.658

Cite this article as:
Mantell, J.E., Hoffman, S., Weiss, E. et al. J Urban Health (2001) 78: 658. doi:10.1093/jurban/78.4.658

Abstract

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.

Keywords

AcceptabilityDual protectionFamily planningFemale condomHealth care providersHIV/AIDS and STD preventionTraining
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Copyright information

© The New York Academy of Medicine 2001