Female and Male Condoms: Whose Responsibility?

Female condoms for women, male condoms for men? Not so fast!

Last week I attended an NGO
session at the UN Commission on the Status of Women called "Female and
Male Condoms: Men and Women Sharing Responsibility for Prevention,"
organized by the Center
for Health and Gender Equity

(CHANGE) and co-sponsored by the United
Nations Population Fund

Vaccine Advocacy Coalition

(AVAC) and several other non-governmental organizations and UN agencies. 
While underscoring the need for effective programming and advocacy around
female and male condoms, the session aimed to debunk the misconception
that male condoms should be used and initiated by men and female condoms
should be used and initiated by women. 

"I would love to go back
in time and change the name of the ‘female condom,’" said Mitchell
Warren, executive director of the AIDS
Vaccine Advocacy Coalition
who spoke at the session.  It’s not that he was discounting the
importance of female condoms for women’s reproductive health and empowerment. 
After all, female condoms are still the only
available HIV and pregnancy prevention method designed for women’s
initiation, and they can help put the power of prevention in women’s
hands.  Rather, "female" condom is a misnomer, since it obscures
the fact that men can and do initiate female condom negotiation, and
often participate in their insertion and use. 

According to panelist Edinah
Masiyiwa, executive director of the Women’s
Action Group
of Zimbabwe, many men in WAG’s male and female condom trainings prefer
to lead insertion of the female condom when having intercourse with
their female partners.  And the exciting thing about men getting
involved in female condom use is that it can help improve and increase
communication between partners, contribute toward joint responsibility
for HIV prevention and even lead to increased pleasure and satisfaction. 

The same concept holds true
for male condoms, which tend to be implicitly associated with men. 
But we know that many women play a major role in male condom use and
initiation-from suggesting that men use a condom to actually putting
it on their partner.  I think it’s safe to say that this "dichotomy"
between men / women and female condoms / male condoms is false, and
both women and men have roles and responsibilities when it comes to
negotiating and using female and male condoms. 

But how do we get to a place
where partner negotiation and communication around condom use are fluid
and non-threatening, where women and men assume equal responsibility
for initiating HIV prevention? 

As Mitchell stated, "products
don’t protect people, people do."  Male and female condoms
that sit in warehouses or on store counters aren’t protecting people. 
Even condoms that aren’t used correctly aren’t fully protecting
people!  Women and men who use condoms correctly and consistently
protect themselves and each other, but they can’t do it alone. 
Women and men – and youth – must have access to female and male condoms
and to education and skills-building programs, particularly in cultures
and locations where condoms are stigmatized.   

Comprehensive sex education
is one critical avenue for cultivating these skills, but it must be
truly "comprehensive."  Maxwell Ciardullo of the Sexuality Information
and Education Council of the United States

(SIECUS) stressed this during his presentation on the importance of
thorough discussions about condom use within sex education programs
in the U.S.  "We have to make sure we don’t allow ‘comprehensive’
sex ed programs to be abstinence plus a condom demonstration," he

In fact, Maxwell argued we
need to go way beyond a stand-alone condom lesson and take social, environmental
and personal factors into account.  Truly comprehensive programs
should address gender roles and expectations (does a "real" man
carry a condom?  Does a "good" girl carry one?), men and women’s
familiarity and comfort with their sexual anatomy, trust issues, gender-based
violence, sexual orientation (what about condom use for men who have
sex with men and lesbians who may have occasional male partners?), risk
perception and homophobia.   

Edinah echoed Max about the
need for comprehensive sex education and raised additional considerations,
such as cultural sensitivities and the role of pleasure.  For example,
WAG’s trainings in Zimbabwe address cultural issues affecting women’s
agency and their reproductive health, such as violence, wife inheritance
and polygamy.  WAG’s programs on sexual and reproductive health
are holistic, nonjudgmental, and empower participants regardless of
their HIV status, gender or other social location.   

WAG’s programs do not shy
away from talking about male and female condoms in a "sexy" way. 
WAG actively promotes women and men’s right to pleasurable sex, teaching
that condoms can be a tool for pleasure.  For instance, Edinah
reported that many men love the "tickle" they feel from the inner
ring of the female condom, and many women love the "tickle" they
get from the outer ring.   

So where do we go from here? 
"It takes a village to achieve comprehensive responsibility for prevention,"
as Mitchell aptly stated.  Even when women and men have the information
and skills to use female and male condoms effectively, we still need
to ensure that policies and programs are in place to support successful
procurement, distribution and training, in addition to adequate financial

One way people can help make
comprehensive male and female condom programming a reality is to join
the Center for Health and Gender Equity’s Prevention Now! Campaign
at www.preventionnow.net.  The Prevention Now! Campaign
is a global campaign to dramatically increase donor and government funding
for the purchase, distribution and program support needed to expand
access to female and male condoms and other existing prevention options
for women and men, and the campaign is always looking for new advocates.    

HIV/AIDS, women’s rights,
and sexual and reproductive health and rights advocates must demand
access to male and female condom supplies and programming today. 
Together we can bring about policy and program change at the local,
national and global levels-so make your voices heard!