Female and Male Condoms: Whose Responsibility?

Female and Male Condoms: Whose Responsibility?
by Kimberly Whipkey, Senior Associate for Advocacy and Outreach at the Center for Health and Gender Equity

Last week I attended an NGO session at the UN Commission on the Status of Women called "Female and Male Condoms: Men and Women Sharing Responsibility for Prevention," organized by the Center for Health and Gender Equity (CHANGE) and co-sponsored by the United Nations Population Fund (UNFPA), the AIDS Vaccine Advocacy Coalition (AVAC) and several other non-governmental organizations and UN agencies.  While underscoring the need for effective programming and advocacy around female and male condoms, the session aimed to debunk the misconception that male condoms should be used and initiated by men and female condoms should be used and initiated by women. 

"I would love to go back in time and change the name of the ‘female condom,'" said Mitchell Warren, executive director of the AIDS Vaccine Advocacy Coalition, who spoke at the session.  It's not that he was discounting the importance of female condoms for women's reproductive health and empowerment.  After all, female condoms are still the only available HIV and pregnancy prevention method designed for women's initiation, and they can help put the power of prevention in women's hands.  Rather, "female" condom is a misnomer, since it obscures the fact that men can and do initiate female condom negotiation, and often participate in their insertion and use. 

According to panelist Edinah Masiyiwa, executive director of the Women's Action Group (WAG) of Zimbabwe, many men in WAG's male and female condom trainings prefer to lead insertion of the female condom when having intercourse with their female partners.  And the exciting thing about men getting involved in female condom use is that it can help improve and increase communication between partners, contribute toward joint responsibility for HIV prevention and even lead to increased pleasure and satisfaction. 

The same concept holds true for male condoms, which tend to be implicitly associated with men.  But we know that many women play a major role in male condom use and initiation-from suggesting that men use a condom to actually putting it on their partner.  I think it's safe to say that this "dichotomy" between men / women and female condoms / male condoms is false, and both women and men have roles and responsibilities when it comes to negotiating and using female and male condoms. 

But how do we get to a place where partner negotiation and communication around condom use are fluid and non-threatening, where women and men assume equal responsibility for initiating HIV prevention? 

As Mitchell stated, "products don't protect people, people do."  Male and female condoms that sit in warehouses or on store counters aren't protecting people.  Even condoms that aren't used correctly aren't fully protecting people!  Women and men who use condoms correctly and consistently protect themselves and each other, but they can't do it alone.  Women and men - and youth - must have access to female and male condoms and to education and skills-building programs, particularly in cultures and locations where condoms are stigmatized.  

Comprehensive sex education is one critical avenue for cultivating these skills, but it must be truly "comprehensive."  Maxwell Ciardullo of the Sexuality Information and Education Council of the United States (SIECUS) stressed this during his presentation on the importance of thorough discussions about condom use within sex education programs in the U.S.  "We have to make sure we don't allow ‘comprehensive' sex ed programs to be abstinence plus a condom demonstration," he said.   

In fact, Maxwell argued we need to go way beyond a stand-alone condom lesson and take social, environmental and personal factors into account.  Truly comprehensive programs should address gender roles and expectations (does a "real" man carry a condom?  Does a "good" girl carry one?), men and women's familiarity and comfort with their sexual anatomy, trust issues, gender-based violence, sexual orientation (what about condom use for men who have sex with men and lesbians who may have occasional male partners?), risk perception and homophobia.   

Edinah echoed Max about the need for comprehensive sex education and raised additional considerations, such as cultural sensitivities and the role of pleasure.  For example, WAG's trainings in Zimbabwe address cultural issues affecting women's agency and their reproductive health, such as violence, wife inheritance and polygamy.  WAG's programs on sexual and reproductive health are holistic, nonjudgmental, and empower participants regardless of their HIV status, gender or other social location.  

WAG's programs do not shy away from talking about male and female condoms in a "sexy" way.  WAG actively promotes women and men's right to pleasurable sex, teaching that condoms can be a tool for pleasure.  For instance, Edinah reported that many men love the "tickle" they feel from the inner ring of the female condom, and many women love the "tickle" they get from the outer ring.   

So where do we go from here?  "It takes a village to achieve comprehensive responsibility for prevention," as Mitchell aptly stated.  Even when women and men have the information and skills to use female and male condoms effectively, we still need to ensure that policies and programs are in place to support successful procurement, distribution and training, in addition to adequate financial investment. 

One way people can help make comprehensive male and female condom programming a reality is to join the Center for Health and Gender Equity's Prevention Now! Campaign at www.preventionnow.net. The Prevention Now! Campaign is a global campaign to dramatically increase donor and government funding for the purchase, distribution and program support needed to expand access to female and male condoms and other existing prevention options for women and men, and the campaign is always looking for new advocates.    

HIV/AIDS, women's rights, and sexual and reproductive health and rights advocates must demand access to male and female condom supplies and programming today.  Together we can bring about policy and program change at the local, national and global levels-so make your voices heard!