Female-Condom Use in a Gender-Specific Family Planning Clinic Trial

The researchers evaluated female-condom use among women participating in Project FIO (The Future Is Ours), a randomized trial of a gender-specific HIV/STD preventive intervention that was successful in reducing unprotected sex. The authors present data on female-condom use during a 12-month follow-up period among 360 women recruited from a family planning clinic in Brooklyn, N.Y. The women were randomly assigned to an 8- or 4-session intervention group or to a control group, and interviewed at 1-, 6-, and 12-month intervals.

The investigators found that relative to control subjects, women assigned to the 8-session group were more likely to report maintaining consistent safer sexual intercourse practices or decreasing the number of sexual intercourse occasions not protected by a male or female condom, at both the 1-month follow-up and the 12-month follow-up.

The researchers' findings demonstrate a short-term effect of intervention on female condom use. Women in the intervention groups assessed the female condom as more effective against STDs and pregnancy than women in the control group. Although women assigned to intervention groups were willing to try the female condom, that did not translate to sustained use.

"The intervention was the most important predictor of trying the female condom, but repeated use was related to women's comfort in using the female condom after trying it," according to the study. "In open-ended responses, 90 percent of women who found their first experience difficult cited problems with insertion."

Although the female condom has been touted as a method that can be used without a partner's support, the researchers found "several indications of male partners' influence on women's response to the female condom." They noted that other studies have also reported that men's reactions to the female condom are important predictors of women's use.

"From the studies of female-condom interventions conducted to date, we conclude that cognitive-behavioral interventions grounded in a gender-sensitive framework can increase women's ability to negotiate with their partners about female-condom use and promote first-time female-condom use. At present, however, the female condom seems to be difficult for women to adopt without more extensive trainings in its use," the authors concluded. "Our data suggest that interventions designed to offer women greater opportunities to become comfortable with insertion and to garner the support of male partners may be more effective in increasing long-term use. Public policy changes are warranted as well, including increased promotion and price support, especially now that some studies have shown that it is safe to reuse the female condom after washing. Without concurrent individual and structural interventions, the potential of the female condom to contribute to disease reduction will not be achieved."

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