Integrating Female Condoms into HIV Prevention Programs: A Case Study of Barriers, Facilitators, and Future Opportunities in Kenya

Female condoms are an important option for dual protection from unintended pregnancy and HIV and other sexually transmitted infections, especially when male condoms cannot be used. Incorporating female condoms into other HIV prevention channels is a potential strategy to increase access for women and men in need of dual protection beyond male condoms. Policies recommend incorporating female condoms into two HIV prevention programs that have gained significant momentum and political support -- prevention of mother-to-child transmission of HIV (PMTCT) and voluntary medical male circumcision (VMMC). However, there is a lack of clarity on how female condoms are being included at the programmatic level

Can Condoms Be Compelling? Examining the State Interest in Confiscating Condoms from Suspected Sex Workers

Confiscating condoms from suspected sex workers leaves them at risk for HIV/AIDS, other sexually transmitted diseases, and unwanted pregnancy. Yet, police officers in New York, Washington, D.C., and Los Angeles collect condoms from sex workers to use against them as evidence of prostitution. Sometimes, the condoms are taken solely for the purpose of harassment. These actions put sex workers at risk of contracting sexually transmitted diseases because they may continue to engage in sex work without using protection. In the landmark case of Griswold v. Connecticut, the U.S. Supreme Court established a fundamental privacy right in the use and access of contraceptive devices. While this right has been examined in the context of married couples and individuals, it has not been applied to the confiscation of condoms, a contraceptive device, by police officers. This Note shows that by taking condoms from suspected sex workers, police officers and departments are actually violating sex workers’ constitutional right to privacy, and, therefore, the practice must be abandoned

Can Condoms Be Compelling? Examining the State Interest in Confiscating Condoms from Suspected Sex Workers

Confiscating condoms from suspected sex workers leaves them at risk for HIV/AIDS, other sexually transmitted diseases, and unwanted pregnancy. Yet, police officers in New York, Washington, D.C., and Los Angeles collect condoms from sex workers to use against them as evidence of prostitution. Sometimes, the condoms are taken solely for the purpose of harassment. These actions put sex workers at risk of contracting sexually transmitted diseases because they may continue to engage in sex work without using protection. In the landmark case of Griswold v. Connecticut, the U.S. Supreme Court established a fundamental privacy right in the use and access of contraceptive devices. While this right has been examined in the context of married couples and individuals, it has not been applied to the confiscation of condoms, a contraceptive device, by police officers. This Note shows that by taking condoms from suspected sex workers, police officers and departments are actually violating sex workers’ constitutional right to privacy, and, therefore, the practice must be abandoned

Effectiveness of Male Condoms: Frequently Asked Questions

More than two decades of research and experience have provided new insights into the role of male condoms for contraception and HIV prevention. However, given that the number of people infected and living with HIV continues to grow, it is essential to reassess what we have learned about HIV prevention. This is especially true regarding condoms, the controversial mainstay of HIV prevention programs. Opinions on condoms are often based on ideology rather than evidence, though evidence has accumulated steadily. The following is a list of frequently asked questions and answers about condom efficacy

Two heads are better than one: The association between condom decision-making and condom use errors and problems

This is an open access article - Copyright @ 2008 BMJ Publishing GroupObjectives: This exploratory study compared the frequency of condom use errors and problems between men reporting that condom use for penile–vaginal sex was a mutual decision compared with men making the decision unilaterally. Methods: Nearly 2000 people completed a web-based questionnaire. A sub-sample of 660 men reporting that they last used a condom for penile–vaginal sex (within the past three months) was analysed. Nine condom use errors/problems were assessed. Multivariate analyses controlled for men’s age, marital status, and level of experience using condoms. Results: Men’s unilateral decision-making was associated with increased odds of removing condoms before sex ended (adjusted odds ratio (AOR) 2.51, p=0.002), breakage (AOR 3.90, p=0.037), and slippage during withdrawal (AOR 2.04, p=0.019). Men’s self-reported level of experience using condoms was significantly associated with seven out of nine errors/problems, with those indicating less experience consistently reporting more errors/problems. Conclusions: Findings suggest that female involvement in the decision to use condoms for penile–vaginal sex may be partly protective against some condom errors/problems. Men’s self-reported level of experience using condoms may be a useful indicator of the need for education designed to promote the correct use of condoms. Education programmes may benefit men by urging them to involve their female partner in condom use decisions.Funding for this project was provided by the Canada Research Chair in Social Justice and Sexual Health at the University of Windsor, and the Rural Center for AIDS/STD Prevention and The Kinsey Institute for Research in Sex, Gender, and Reproduction at Indiana University

A Novel Condom Distribution Program for County Jail Prisoners

The Center for AIDS Prevention Studies (CAPS), in collaboration with the Center for Health Justice, the Forensic AIDS Project, and the San Francisco Sheriff's Department, conducted a feasibility study of a novel method of providing condoms to prisoners by installing a condom dispens- ing machine in the San Francisco County Jail.This study begins to address the dearth of research on prisoner condom access programs, a novel component of HIV prevention behavioral interventions among an extremely high-risk population, and to identify a method of providing prisoners condoms on a larger scale than any current program. Further, this pilot feasibility study has the potential to stimulate research on the impact of condom distribution and consideration of legislation in other jurisdictions to allow prisoners access to condoms

Access to condoms for female sex workers in Andhra Pradesh.

BACKGROUND: Condoms are an essential part of comprehensive HIV prevention and care programmes. We report the accessibility of male condoms for female sex workers (FSWs) and the associated characteristics that may play a major role in determining access to condoms for FSWs. METHODS: Confidential interviews of 6509 street- and home-based FSWs in 13 districts of the Indian state of Andhra Pradesh provided data on the number of paying clients and various aspects of access to free condoms and purchase of condoms. Access to condoms was defined as having ever obtained condoms either through free distribution or through purchase. Multivariate analyses were done separately for street- and home-based FSWs to describe correlates of their access to condoms. The requirement of condoms was assessed based on the number of paying clients during the past 15 days. RESULTS: Data on condom access were available for 6465 (99.3%) FSWs. A total of 2850 (44.1%; 95% CI: 36.2%-52.0%) reported accessing free condoms ever and 2336 (36.1%; 95% CI: 30.6%-41.6%) had purchased condoms ever (not mutually exclusive). The primary sources for condoms were non-governmental organization facilities (73.8%) and pharmacies (79.7%) for free and purchased condoms, respectively. A total of 3510 (54.3%; 95% CI: 48.5%-60.1%) FSWs reported no access to free or purchased condoms during the past 15 days, and this no access was significantly higher for those > 30 years of age, with no schooling, street-based FSWs, and with no participation in a FSW support group (p < 0.001 for each in univariate analysis). Participation in a FSW support group was the main predictor of access to free condoms for both types of FSWs during the past 15 days with multivariate analysis. Condom requirements during the past 15 days were met for 67.5% of FSWs who had accessed only free condoms and for 33.8% of those who had accessed only purchased condoms. CONCLUSIONS: One-fourth of FSWs had never accessed condoms, and a little over half of those who had ever accessed reported no access during the past 15 days. Condom requirements were not met for three-fifths of the FSWs. HIV prevention programmes need to Increase access to free condoms for FSWs in Andhra Pradesh as access to condoms is a necessary prerequisite for condom use

Condom Use and Consistency Among Teen Males

This Child Trends study finds that any type of formal sex education is linked with higher levels of condom use at teen males' first sexual experience. However, one in five teen males (ages 15-19) did not receive formal sex education about either abstinence or contraception before having sex for the first time. The study, published in the October 2008 issue of the Journal of Adolescent Health and summarized in this fact sheet, examines how multiple dimensions of teen males' lives are associated with condom use and consistency. Among the findings: --Having an older partner or a casual partner is linked to less condom use. Nearly one-fourth of teen males had an older recent partner and more than one-third were in a casual relationship with their first sexual partner. --Older teen males and those in longer relationships are less likely to use condoms. This was true even after controlling for whether their partner used a contraceptive method. --Positive attitudes about using condoms are linked to actual use. Teen males who disagree with the ideas that condoms reduce physical pleasure and that it would be embarrassing to discuss condom use with a new partner have higher levels of condom use and consistency. --Seven in ten teen males reported using a condom at their first and at their most recent sexual experience, but fewer reported using condoms consistently. Just one-half of sexually active teen males reported using a condom consistently with their most recent sexual partner

Comparing condom use with different types of partners : evidence from national HIV surveys in Africa

Based on nationally representative samples from 13 Sub-Saharan African countries, this paper reinforces and expands previous findings that condom use in general is low in this region, men report using condoms more frequently than women, and unmarried individuals report they use condoms more frequently than married individuals with their spouse. Based on descriptive, bivariate, and multivariate analyses, the authors also demonstrate to a degree not previously shown in the current literature that married men from most countries report using condoms with extramarital partners about as frequently as unmarried men. However, married women from most countries included use condoms with extramarital partners less frequently than unmarried women. This result is especially troubling because marriage usually ensures regular sexual intercourse, providing more opportunities to pass HIV from extramarital partner to spouse than an unmarried person who may also have multiple partners but not as regular sexual intercourse.Population Policies,Gender and Health,Adolescent Health,HIV AIDS,Gender and Law

Reasons for non- use of condoms and self-efficacy among female sex workers: A qualitative study in Nepal

Background Heterosexual contact is the most common mode of transmission of sexually transmitted infections (STIs) including Human Immunodeficiency Virus (HIV) in Nepal and it is largely linked to sex work. We assessed the non-use of condoms in sex work with intimate sex partners by female sex workers (FSWs) and the associated self-efficacy to inform the planning of STI/HIV prevention programmes in the general population. Methods This paper is based on a qualitative study of Female Sex Workers (FSWs) in Nepal. In-depth interviews and extended field observation were conducted with 15 FSWs in order to explore issues of safe sex and risk management in relation to their work place, health and individual behaviours. Results The main risk factor identified for the non-use of condoms with intimate partners and regular clients was low self efficacy. Non-use of condoms with husband and boyfriends placed them at risk of STIs including HIV. In addition to intimidation and violence from the police, clients and intimate partners, clients’ resistance and lack of negotiation capacity were identified as barriers in using condoms by the FSWs. Conclusion This study sheds light on the live and work of FSWs in Nepal. This information is relevant for both the Government of Nepal and Non Governmental Organisations (NGO) to help improve the position of FSWs in the community, their general well-being and to reduce their risks at work