Journal of Urban Health

, Volume 78, Issue 4, pp 658–668 | Cite as

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

  • Joanne E. Mantell
  • Susie Hoffman
  • Eugene Weiss
  • Lawrence Adeokun
  • Grace Delano
  • Temple Jagha
  • Theresa M. Exner
  • Zena A. Stein
  • Quarraisha Abdool Karim
  • Elma Scheepers
  • Kim Atkins
  • Ellen Weiss
Special Feature: Female-Initiated Methods of STI/HIV Prevention

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

Acceptability Dual protection Family planning Female condom Health care providers HIV/AIDS and STD prevention Training 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    World Health Organization. The Female Condom: a Review. Publication number WHO/HRP/WOM/97.1. Geneva, Switzerland: World Health Organization; 1997.Google Scholar
  2. 2.
    Cecil H, Perry MJ, Seal DW, Pinkerton SD. The female condom: what we have learned thus far. AIDS Behav. 1998;2:241–256.CrossRefGoogle Scholar
  3. 3.
    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.PubMedGoogle Scholar
  4. 4.
    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.CrossRefPubMedGoogle Scholar
  5. 5.
    Kim YM, Maranguanda C, Kols A. Quality of counseling of young clients in Zimbabwe. E Afr Med J. 1997;74:4–5.Google Scholar
  6. 6.
    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.Google Scholar
  7. 7.
    Mfono Z. Teenage contraceptive needs in urban South Africa: a case study. Int Fam Plann Perspect. 1998;24:180–183.CrossRefGoogle Scholar
  8. 8.
    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.Google Scholar
  9. 9.
    Brown JW, Boulton ML. Provider attitudes toward dispensing emergency contraception in Michigan's title X programs. Fam Plann Perspect. 1999;31(1):39–43.CrossRefPubMedGoogle Scholar
  10. 10.
    Sharma V, Sharma A. Condom promotion strategies: what we need to know? [letter]. AIDS. 1995;9:537–538.PubMedGoogle Scholar
  11. 11.
    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.CrossRefGoogle Scholar
  12. 12.
    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.CrossRefPubMedGoogle Scholar
  13. 13.
    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.Google Scholar
  14. 14.
    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.Google Scholar
  15. 15.
    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.Google Scholar
  16. 16.
    Joint United Nations Programme on HIV/AIDS. AIDS Epidemic Update: December 2000. Geneva, Switzerland: Joint United Nations Programme on HIV/AIDS. December 2000.Google Scholar
  17. 17.
    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.Google Scholar
  18. 18.
    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.CrossRefPubMedGoogle Scholar
  19. 19.
    Nigeria Population Commission. Nigeria Demographic and Health Survey 1999. Calverton, MD. National Population Commission and ORC/Macro; 2000.Google Scholar
  20. 20.
    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.CrossRefPubMedGoogle Scholar
  21. 21.
    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.Google Scholar
  22. 22.
    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.CrossRefPubMedGoogle Scholar

Copyright information

© The New York Academy of Medicine 2001

Authors and Affiliations

  • Joanne E. Mantell
    • 6
  • Susie Hoffman
    • 6
  • Eugene Weiss
    • 2
  • Lawrence Adeokun
    • 2
  • Grace Delano
    • 2
  • Temple Jagha
    • 2
  • Theresa M. Exner
    • 6
  • Zena A. Stein
    • 6
  • Quarraisha Abdool Karim
    • 1
  • Elma Scheepers
    • 3
  • Kim Atkins
    • 4
  • Ellen Weiss
    • 5
  1. 1.Joseph Mailman School of Public HealthColumbia University, Division of EpidemiologyNew York
  2. 2.Association for Reproductive and Family HealthIbadanNigeria
  3. 3.the Department of Public WorksCommunity Development ProgrammePretoriaSouth Africa
  4. 4.the Community Health Care NetworkNew York
  5. 5.the International Center for Research on Women and HorizonsWashington, DC
  6. 6.HIV Center for Clinical and Behavioral StudiesNew York State Psychiatric Institute/Columbia UniversityNew York

Personalised recommendations