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  • Title: Women's attitudes to condoms and female-controlled means of protection against HIV and STDs in south-western Uganda.
    Author: Hart GJ, Pool R, Green G, Harrison S, Nyanzi S, Whitworth JA.
    Journal: AIDS Care; 1999 Dec; 11(6):687-98. PubMed ID: 10716009.
    Abstract:
    The consistent and correct use of the male condom makes it highly effective in both disease prevention and as a contraceptive method. However, it is also well recognized that its use is under men's control. Because of this vital limitation, there have been frequent calls for female-controlled methods of HIV prevention, particularly from women from sub-Saharan Africa. Here we report on data collected in focus-group discussions (FGDs) with women aged 17-54 in South-Western Uganda. A total of 138 women, from rural villages, urban family planning clinics and a truck-stop town, were recruited to participate in 18 FGDs on the male condom, the female condom and existing formulations of vaginal microbicidal products. Three themes emerged: (i) problems with men's control over the male condom, (ii) the importance of control over and secrecy about protective measures and (iii) sexual pleasure associated with different methods. We found that the female condom, while being perceived as an improvement over the male condom, was recognized as having limited value because of the need to agree its use prior to sex taking place. Other products were considered to be significantly better than the female condom; the sponge, in particular, was perceived as having advantages over every other product. Women like the fact that it could be inserted some time before, and left in place some time after, sexual intercourse, that it was effective for multiple instances of intercourse, and that men would be unaware that it was being employed. Female-controlled methods to prevent sexually transmitted infections, including HIV, and to increase reproductive choice, hold the promise of ceding some control over sexual and reproductive health to women. A focus group discussion with 138 women aged 17-54 in southwestern Uganda was undertaken to investigate the acceptability of female-controlled methods of HIV and sexually transmitted disease prevention. There were three themes that emerged from the discussion: 1) problems with men's control over the male condom; 2) the importance of control over and secrecy about protective measures; and 3) sexual pleasure associated with the different methods. Findings revealed that the female condom, while it was perceived as an improvement over the male condom, was recognized to have a limited value because of the need to agree about its use prior to sexual intercourse. Other products were considered to be significantly better than the female condom--the sponge, in particular. Women liked the fact that it could be inserted some time before, and left in place some time after sexual activity. Moreover, it was effective for multiple instances of intercourse, and those men would be unaware that it was being employed. Female-controlled methods to prevent sexually transmitted infections, including HIV, and to increase reproductive choice, hold the promise of providing some control over sexual and reproductive health to women.
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