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AIDS and Behavior

, Volume 18, Issue 1, pp 146–158 | Cite as

Prevalence of Knowledge and Use of the Female Condom in South Africa

  • Fiona M. Guerra
  • Leickness C. SimbayiEmail author
Original Paper

Abstract

Male condoms remain a key tool in preventing the spread of HIV and the female condom (FC) holds similar potential. Using data collected through a national cross-sectional population survey that was conducted in 2008, this report investigated the national prevalence of FC knowledge and use by sexually active males and females (n = 7,727) over the age of 15 years in South Africa, followed by a closer examination of the sexually active female population alone. Though knowledge of the FC among sexually active females over the age of 15 years (n = 4,551) was relatively high at 77.75 %, use was low at 7.16 %. The present study found statistically significant associations between knowledge or use of the FC and several demographic variables for females in South Africa. Having heard of the FC was consistently associated with locality, province, age, education level, marital status, and employment status. Use of the FC, however, was only associated with province and age group. Many demographic groups exhibited a high prevalence of knowledge but a low level of use; or conversely, a low prevalence of knowledge but a high level of use compared to their counterparts. Our findings support the need for a rigorous campaign to promote the use of FCs by women and also to increase their availability in public health sector facilities such as government clinics and hospitals in order to improve the chance of women using the FC, a cost-effective device that has the potential to protect both their rights and lives.

Keywords

Female condom HIV prevention for women HIV/AIDS South Africa Women’s sexual and reproductive rights 

Notes

Acknowledgments

This research has been supported by the President’s Emergency Plan for AIDS Relief (PEPFAR) through CDC under the terms of Cooperative Agreement Number U2GPS000570-03. The Fiona M. Guerra was supported by the Canadian International Development Agency (CIDA) International Youth Internship Program (IYIP) during her sojourn at the HSRC from June 2012 until December 2012. The authors would like to thank HSRC staff who were involved in both planning and implementing the 2008 South African National HIV Prevalence, HIV Incidence, Behaviour and Communications Survey as well as the South African public for agreeing to participate in the survey.

References

  1. 1.
    Drew WL, Blair M, Miner RC, Conant M, Drew WL. Evaluation of the virus permeability of a new condom for women. Sex Transm Dis. 1990;17(2):110–2.PubMedCrossRefGoogle Scholar
  2. 2.
    Lytle CD, Routson LB, Seaborn GB, Dixon LG, Bushar HF, Cyr WH. An in vitro evaluation of condoms as barriers to a small virus. Sex Transm Dis. 1997;24(3):161–4.PubMedCrossRefGoogle Scholar
  3. 3.
    Macaluso M, Lawson ML, Hortin G, et al. Efficacy of the female condom as a barrier to semen during intercourse. Am J Epidemiol. 2003;157(4):289–97.PubMedCrossRefGoogle Scholar
  4. 4.
    American Foundation for AIDS Research. The effectiveness of condoms in preventing HIV transmission. Issue Brief 1. Washington: AMFAR 2005. Available at: http://www.amfar.org/uploadedFiles/In_the_Community/Publications/condombrief.pdf. Accessed 1 Nov 2012.
  5. 5.
    South African National AIDS Council. National Strategic Plan on HIV, STI and TB 2012-2016. SANAC, 2011. Available at: http://www.doh.gov.za/docs/stratdocs/2012/NSPfull.pdf. Accessed 1 Nov 2012.
  6. 6.
    Dowdy DW, Sweat MD, Holtgrave DR. Country-wide distribution of the nitrile female condom (FC2) in Brazil and South Africa: a cost-effectiveness analysis. AIDS. 2006;20(16):2091–8.PubMedCrossRefGoogle Scholar
  7. 7.
    Marseille E, Kahn JG, Billinghurst K, Sabad J. Cost-effectiveness of the female condom in preventing HIV and STDs in commercial sex workers in rural South Africa. Soc Sci Med. 2001;52:135–48.PubMedCrossRefGoogle Scholar
  8. 8.
    Hoke TH, Feldblum PJ, Van Damme K, et al. Temporal trends in sexually transmitted infection prevalence and condom use following introduction of the female condom to Madagascar sex workers. Int J STD AIDS. 2007;18(7):461–6.PubMedCrossRefGoogle Scholar
  9. 9.
    Ray S, Bassett M, Maposhere C, et al. Acceptibility of the female condom in Zimbabwe: positive but male-centred responses. Reprod Health Matters. 1995;3(5):68–79.CrossRefGoogle Scholar
  10. 10.
    Pettifor AE, Beksinska ME, Rees HV, Mqoqi N, Dickson-Tetteh KE. The acceptability of reuse of the female condom among urban South African women. J Urban Health. 2001;78(4):647–57.PubMedCrossRefGoogle Scholar
  11. 11.
    Smith JB, Nkhama G, Trottier DA. Female condom reuse in Lusaka, Zambia: evidence from 12 cases. J Urban Health. 2001;78(4):638–46.PubMedCrossRefGoogle Scholar
  12. 12.
    Beksinska ME, Rees HV, Dickson-Tetteh KE, Mqoqi N, Kleinschmidt I, McIntyre JA. Structural integrity of the female condom after multiple uses, washing, drying, and re-lubrication. Contraception. 2001;63(1):33–6.PubMedCrossRefGoogle Scholar
  13. 13.
    WHO. Considerations regarding reuse of the female condom: information update. Geneva: WHO, 10 July 2002. Available at: http://www.who.int/reproductivehealth/topics/rtis/reuse_FC2_info_update.pdf. Accessed 1 Nov 2012.
  14. 14.
    Joanisa C, Beksinska M, Harta C, Tweedy K, Linda J, Smit J. Three new female condoms: which do South-African women prefer? Contraception. 2011;83:248–54.CrossRefGoogle Scholar
  15. 15.
    Peters A, Jansen W, van Drielc F. The female condom: the international denial of a strong potential. Reprod Health Matters. 2010;18(35):119–28.PubMedCrossRefGoogle Scholar
  16. 16.
    Renzi C, Tabet SR, Stucky JA, et al. Safety and acceptability of the Reality condom for anal sex among men who have sex with men. AIDS. 2003;17(5):727–31.PubMedCrossRefGoogle Scholar
  17. 17.
    Johnson WD, Diaz RM, Flanders WD et al. Behavioral interventions to reduce risk for sexual transmission of HIV among men who have sex with men. Cochrane Database Syst Rev. 2008 Jul 16; (3):CD001230.Google Scholar
  18. 18.
    Gross M, Buchbinder SP, Holte S, Celum CL, Koblin BA, Douglas JM Jr. Use of reality “female condoms” for anal sex by US men who have sex with men. Am J Public Health. 1999;89(11):1739–41.PubMedCrossRefGoogle Scholar
  19. 19.
    UNDP/UNFPA/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction. The Female Condom: A review. Geneva: World Health Organization, 1997.Google Scholar
  20. 20.
    Vijayakumar G, Mabude Z, Smit J, Beksinska M, Lurie M. A review of female-condom effectiveness: patterns of use and impact on protected sex acts and STI incidence. Int J STD AIDS. 2006;17(10):652–9.PubMedCrossRefGoogle Scholar
  21. 21.
    Beksinkska ME, Smit JA, Mantell JE. Progress and challenges to male and female condom use in South Africa. Sex Health. 2012;9(1):51–8.CrossRefGoogle Scholar
  22. 22.
    Beksinska ME, Rees VH, McIntyre JA, Wilkinson D. Acceptability of the female condom in different groups of women in South Africa-a multicentered study to inform the national female condom introductory strategy. S Afri Med J. 2001;91:672–8.Google Scholar
  23. 23.
    Kaler A. The future of female-controlled barrier methods for HIV prevention: female condoms and lessons learned. Cult Health Sex. 2004;6(6):501–16.CrossRefGoogle Scholar
  24. 24.
    Hoffman S, Mantell J, Exner T, Stein Z. The future of the female condom. Int Fam Plan Perspect. 2004;30(3):139–45.PubMedCrossRefGoogle Scholar
  25. 25.
    Mantell JE, Dworkin SL, Exner TM, Hoffman S, Smit JA, Susser I. The promises and limitations of female-initiated methods of HIV/STI protection. Soc Sci Med. 2006;63(8):1998–2009.PubMedCrossRefGoogle Scholar
  26. 26.
    Mantell JE, Stein ZA, Susser I. Women in the time of AIDS: barriers, bargains, and benefits. AIDS Educ Prev. 2008;20(2):91–106.PubMedCrossRefGoogle Scholar
  27. 27.
    Shisana O, Rehle T, Simbayi LC, et al. South African National HIV Prevalence, Incidence, Behaviour and Communication Survey, 2008: a turning tide among teenagers?. Cape Town: HSRC Press; 2009.Google Scholar
  28. 28.
    van Loggerenberg F, Dieter AA, Sobieszczyk ME, et al. HIV prevention in high-risk women in South Africa: condom use and the need for change. PLoS ONE. 2012;7(2):e30669.PubMedCentralPubMedCrossRefGoogle Scholar
  29. 29.
    Department of Health. Medical Research Council, OrcMarco. South African Demographic and Health Survey 2003. Pretoria: South Africa Department of Health, 2007. Available at: http://www.mrc.ac.za/bod/sadhs.htm. Accessed 1 Nov 2012.
  30. 30.
    Ackerman L, de Klerk G. Social factors that make South African women vulnerable to HIV infection. Health Care Women Int. 2002;23(2):163–72.CrossRefGoogle Scholar
  31. 31.
    Shisana O, Louw J. ‘Missing the women’: exploring key challenges in policy responses to HIV/AIDS. In: Prince B, Louw J, Roe K, Adams R, editors. Exploring the challenges of HIV/AIDS: seminar proceedings. Cape Town: HSRC Press; 2007.Google Scholar
  32. 32.
    UNAIDS. Country Progress Report On The Declaration of Commitment on HIV/AIDS. Final Report, Republic of South Africa, 2010. Available at: http://data.unaids.org/pub/report/2010/southafrica_2010_country_progress_report_en.pdf. Accessed 1 Nov 2012.
  33. 33.
    Warren M, Philpott A. Expanding safer sex options: introducing the female condom into national programmes. Reprod Health Matters. 2003;11(21):130–9.PubMedCrossRefGoogle Scholar
  34. 34.
    Oxfam Novib. A matter of choice rather than noise. International meeting on the female condom. Netherlands: Oegstgeest; 2007.Google Scholar
  35. 35.
    Fishbein M, Ajzen I. Belief, attitude, intention and behavior: an introduction to theory and research. Reading: Addison-Wesley; 1975.Google Scholar
  36. 36.
    Fisher JD, Fisher WA. Theoretical approaches to individual-level change in HIV risk behavior. In: Peterson JL, DiClemente RJ, editors. Handbook of HIV prevention. New York: Kluwer Academic/Plenum; 2000. p. 3–55.CrossRefGoogle Scholar
  37. 37.
    Rehle T, Lazzari S, Dallabetta G, Asamoah-Odei E. Second-generation HIV surveillance: better data for decision-making. Bull World Health Organ. 2004;82(2):121–7.PubMedCentralPubMedGoogle Scholar
  38. 38.
    Health Systems Trust. The District Health Barometer 2008/09. In: Monticelli F, Barron P, Haynes R, Smith J, Sello E (eds). Health Systems Trust, May 2010. Available at: http://www.hst.org.za/publications/district-health-barometer-200809. Accessed 1 Nov 2012.
  39. 39.
    Parker F. Mail & Guardian Online. Hunt is on for elusive female condom. Available at: http://mg.co.za/print/2010-08-05-hunt-is-on-for-elusive-female-condom.
  40. 40.
    Thohoyandou Victim Empowerment Programme. The 2008 Thohoyandou victim empowerment dialogues: universal access to female condoms. A human rights issue. Available at: http://www.health-e.org.za/uploaded/eb36b4d2e02db96e65f255bf44498b38.pdf. Accessed 1 Nov 2012.
  41. 41.
    Shisana, O., Peltzer, K, Zungu-Dirwayi, N. & Louw, J. (Eds). The Health of our educators: A focus on HIV/AIDS in South African public schools. Report on factors determining educator supply and demand in South African Schools funded and prepared for the Education Labour Research Council. Cape Town: HSRC Press, 2005.Google Scholar
  42. 42.
    SANAC Women’s Sector. The crisis of the female condom; 2012. Available at http://www.sanacws.org.za/af/announcements/view/the-crisis-of-the-female-condom. Accessed 1 Nov 2012.

Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  1. 1.Human Sciences Research Council, HIV/AIDS, STIs, TB (HAST) UnitCape TownSouth Africa
  2. 2.James P Grant School of Public Health, BRAC UniversityDhakaBangladesh
  3. 3.Department of Psychiatry & Mental HealthUniversity of Cape TownCape TownSouth Africa

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