Study Cites Health, Cost Benefits of D.C. Female Condom Program

A female condom promotion campaign in the District of Columbia averted 23 HIV infections in its first year, saving millions of dollars in future care costs, a new study suggests.

In 2010, the District and community organizations began promoting the second-generation female condom (FC2) in areas with high HIV rates. A $500,000 grant from the MAC AIDS Fund, a philanthropic arm of MAC Cosmetics, helped the District purchase FC2s at wholesale. The project trained peer educators, including hairstylists, to encourage women to talk comfortably about sexual health. Through beauty salons, small grocers, community clinics, and other venues, the District distributed 200,000 free female condoms in the program's first year.

The researchers assumed about 65 percent of the condoms, or 130,000, were actually used during sex. Factoring-in area HIV prevalence and STD rates, the study weighed the risk of HIV infection and the preventive efficacy of female condoms. At least 3 percent of District residents have HIV/AIDS.

Given the lifetime medical cost of HIV, estimated at $367,134 per infected person, and the effort's first-year cost of $414,186, the 23 HIV infections prevented represented more than $8 million in savings, the study found. The District plans to distribute 250,000-300,000 female condoms annually.

"When we think about what it means for a city or state to have a comprehensive HIV program, this study really says you ought to include female condoms as one element of a comprehensive program because it's acceptable, effective, and cost-saving," said David Holtgrave, a study co-author with the Johns Hopkins School of Public Health. For some women with HIV, "They're saying, 'I can have sex again,'" said Greg Pappas, co-author and senior deputy director with the D.C. Department of Health.

The study, "Cost-Utility Analysis of a Female Condom Promotion Program in Washington, DC," was published early online by AIDS and Behavior (2012;doi:10.1007/s10461-012-0174-5).

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