Rubber with a difference

16 Dec 2007, 0000 hrs IST,Saira Kurup,TNN

Talk about a well-oiled instrument. The unsheathing of the female condom (FC) could well give women control over their health and in the bedroom, adding a new meaning to women’s empowerment. This simple polyurethane sheath acts as a dual protection for preventing both unwanted pregnancy and infection.

Achieving these twin objectives may be a tough call in a country where the sexuality of a large proportion of women is, by and large, smothered in a culture of silence, aided by illiteracy and economic dependence on men. It makes them vulnerable to sexually-transmitted infections (STIs) and dangerous pregnancies if their partners are unwilling to use protection.

The FC was introduced a few years ago to address this need. As a commercial product, its market price (Rs 250 for two) is a major deterrent for many. To counter this problem, Hindustan Latex Family Planning Promotion Trust (HLFPPT) teamed up with NACO and UK-based Female Health Foundation to import and distribute FCs among high-risk groups such as female sex workers (FSWs) under a pre-programming study this year.

More than 12,500 FSWs in six states – Andhra Pradesh, Tamil Nadu, Karnataka, Maharashtra, West Bengal and Gujarat – were given FCs at a highly-subsidised rate of Rs 5. “For a long time, prevention (of STIs) depended on the use of condoms by men,” says G Manoj, CEO, HLFPPT. “Now we tell women it’s in their hands to protect themselves.”

Introducing a new technology that affects sexual behaviour is challenging because of the varied dynamics that exist between partners and the stigma attached to condom use, male or female. Studies in Papua New Guinea and Jamaica found that condom use could result in violence against women as men feared it was licence for their women to become promiscuous.

Even sex workers, says G Bhargavi, programme manager, FC programme, HLFPPT, “are advised to inform clients about the use of FC because there have been cases of violence where a client wasn’t told.” She adds, “If the client still refuses to agree, then we advise the sex worker to reject him.”

While NGOs sell FCs to sex workers, HLFPPT has also roped in a women’s self-help group in Tamil Nadu and two NGOs in Rajasthan and UP which are studying the response among married couples. Says Manoj, “The response from Maharashtra, TN, AP and WB has been so good that we plan to scale up the programme soon to cover all NGOs working with sex workers in these states.”

As an anti-HIV measure, the FC is said to be 98.5% successful, though more studies are required. Says Bhargavi, “Sex workers see themselves being protected from all kinds of infections. Also, in some cases, men are paying them more to use FCs because they realise they themselves and their families are being protected too.”

The women also learn to negotiate better with men, by saying ‘‘this is for your pleasure and our protection’’. They also learn about female anatomy from peer educators and to avoid risky relationships.

A 2004 study by HLFPPT in AP, Kerala and Maharashtra said while the biggest barrier to FC acceptability was partner perception and acceptance, a huge plus, even among married couples, is that it’s seen as a women-initiated method, leading to their empowerment in decision-making. It can be used in situations that arise too often with sex workers, where the male client refuses to wear a condom or is too drunk to do so.

Bhargavi says, “A good number of sex workers are using FCs to fill the gaps in male condom usage.” According to Manoj, of the 1.3 billion male condoms that are given free in India by the government, 50% are going waste.

But the FC is not positioned as an alternative to the male condom. Bhargavi says, “The sex worker always offers the male condom first.” And both condoms cannot be used together.

Users have expressed concerns over the difficulty and privacy required to insert the FC. But with an improved version on the anvil, its performance will get better!


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