The vast majority of research on acceptance of female condoms has been conducted among women – with one of the conclusions being that men may be an obstacle to women using them. However, very little evidence existed about men’s opinions of the female condom and whether indeed they do not want their partners to use them and why. This is why UAFC in 2011 commissioned a study on male acceptance of female condoms and the role men play in the use of female condoms.
A three-country qualitative study on male acceptance of female condoms in Zimbabwe, Cameroon, and Nigeria was carried out by a team of researchers from AIID, Amsterdam Institute for International Development and AIGHD, Amsterdam Institute for Global Health and Development.
The main study report and the reports of the three country studies are:
- Male acceptance study
- Male acceptance – Cameroon
- Male acceptance – Nigeria
- Male acceptance – Zimbabwe
The conclusion of the study is that female condom programmes should consider men to be an opportunity in increasing female condom uptake rather than a hindrance. Male frequent users in the study reported to like sex with a female condom and believe in its effectiveness as a contraceptive and for STI and HIV protection. There seems to be a particular scope for promoting female condom use in relationships of trust. To make female condoms more accepted by men and to spread use of the female condoms, personal as well as external factors influencing acceptance and use should be considered, including local dominant gender power relations in different sexual relationships. In doing so, it is important not to put female condoms and other methods forward as an either-or choice, but to promote them as complementary, to both men and women. Hence, the importance of involving and targeting men in female condom promotion and awareness raising activities.
Two of the three countries involved in the study are countries where UAFC is active, Cameroon and Nigeria; the Zimbabwe programme, run by PSI was also included in the study, as it is one of the oldest female condom programmes.
This Female Condom functionality study (Lancet), funded by the UAFC and carried out by MatCH (Maternal Adolescent and Child Health) of the University of The Witwatersrand, South Africa, was undertaken in 2011-2012. The trial aimed to assess the functional performance (breakage, slippage, invagination and misdirection) and safety of three new condom types — the Woman’s Condom, the VA worn-of-women (VA w.o.w.) Condom Feminine, and the Cupid female condom — against the widely available WHO/UNFPA prequalified female condom from the Female Health Company; the FC2.
This randomised controlled, crossover trial was carried out in China and South Africa. The 600 women who took part in the trial were aged 18–45 years, sexually active, monogamous, not pregnant, not allergic to condoms, using another reliable, non-barrier method of contraception, and had no visible or reported sexually transmitted infections. Women were asked to use five of each female condom type and were interviewed after use of each type. We also assessed safety data for each type. In total 572 women completed all their follow-up visits, and these women used at least one female condom of each of the four female condom types in the study.
This has been the largest and most comprehensive functionality trial to date and has provided important function data for these devices and has been used to compile evidence for WHO/UNFPA prequalification. Because of this trial, the Cupid condom has already been approved by WHO/UNFPA and is available for public sector procurement. Manufacturers of the other female condom products are using these data in their ongoing applications to regulatory authorities. Access to various female condom products could improve choice for women in need of a contraceptive method that offers dual protection against unintended pregnancy and sexually transmitted infections, including HIV.