Time to Try Again with Female Condoms

14 Apr

Female condoms are something of an anomaly in the world of contraceptive technologies. Particularly in developing countries, where Western funded ‘reproductive health’ NGOs are obsessed with the sexual behavior of Africans and Asians. So much so that the health aspect is often lost, as in the case of injectable Depo Provera and similar hormonal contraceptives, where any kind of skin piercing is involved. All skin piercing procedures should take place in hygienic conditions, which are certainly not guaranteed in developing country hospitals, let alone other places where these procedures take place, such as rural clinics run by community volunteers, informal pharmacies that obligingly ‘do’ injections and the like.

But if you ask people about female condoms they are vague. They have heard of them, they have heard they are good/bad, they have heard they slip off/don’t slip off, etc. In other words, they are even less well informed about female condoms than they are about male condoms. Male condoms have attracted the censure of various parties, especially churches, which were quick to recognize that most of their parishioners, male and female, really didn’t want to use them, and were happy to adopt any excuse. All the population control organizations could do was try to balance the lies of the churches. But they introduced distortions of their own, about the bliss that comes from small family sizes, such as adequate healthcare, good education, infrastructure, economic success and the like.

The idea that smaller family sizes alone would help was ridiculous. Anyone could see that if educational and health institutions were collapsing, teachers and health workers were not being replaced, were badly trained, supported and paid, that the economy was collapsing and that the majority of people subsisted on a pittance, etc, everyone having smaller families would not be enough to turn things round. But population control NGOs need their myths, just as churches do, just as free market ideologies do, for that matter. Besides, these NGOs were founded on the idea that development, poverty, poor health and education, just about everything wrong with the developing world, was a matter of population control; it’s how they originally got their funding. Once condoms were also proposed as a means of reducing HIV transmission, these organizations were suddenly rolling in it.

But I found out very little about female condoms when I asked people engaged in commercial sex in Kenya. People would start off trotting out something they had heard or read, such as the smell or the noise them made. But only a handful had ever used one and most were happy with what they had heard or read. They are also expensive and didn’t attract the outrageous amounts of funding that male condoms once attracted (though I wonder how many billions of condoms distributed over the last 20 years were never used). Only one woman said she sometimes used them when a client was very drunk; she said they often tried not to use a condom when they were drunk. So she would use a female condom and they wouldn’t notice. Others denied this, but they also admitted they had never used one.

The NGO Pathfinder are currently promoting female condoms, and they also stand out from a lot of other NGOs working in this field by advocating for a woman’s right to choose, in addition to promoting maternal and child health in general, contraception for adolescents (to whom many NGOs can only offer ‘abstinence’), the rights even of people in developing countries to determine their own reproduction related issues, etc. Sadly, Pathfinder don’t yet seem so clear about the fact that reproductive healthcare needs to be safe healthcare and that non-sexually transmitted HIV still needs a lot of attention in countries where health facilities are some of the best environments for starting epidemics (TB in South Africa, Hepatitis C in Egypt, Ebola in Uganda, etc). But maybe that will change as we enter the fourth decade of inordinately high rates of transmission of a virus that should not so easily be transmitted through heterosexual sex.

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