Acceptability of the female condom among STD clinic patients.

ABSTRACT

PIP: The acceptability of the female condom was explored through mixed-gender focus group discussions involving 100 Black and Hispanic men and women recruited from two US inner-city sexually transmitted disease clinics. Before the initial group sessions, 90 participants (90%) had heard about the female condom, 8 (8%) had seen it, and 2 (2%) had used the device. Female participants initially reacted negatively to the condom's appearance, size, and obtrusiveness and expressed uncertainty about how it could be inserted. Male participants, on the other hand, focused on utilitarian rather than aesthetic issues. After handling the device, more than half of female and male participants endorsed a more positive attitude. Women with previous experience with a barrier contraceptive device such as the vaginal diaphragm were more likely to feel comfortable about female condom use. Among the 22 males and 19 females who returned for a second group session after having been given a supply of female condoms to try, 35 (85.4%) had used the device at least once. 10 participants noted that bringing up the topic of female condom use enabled them to discuss safer sex practices with their steady partners for the first time. Women who, in the initial discussions, viewed the female condom as a means of gaining control over their sexuality, gained awareness of the need for substantial male support and cooperation. Men were more comfortable using the device with regular than casual partners, but women made no such distinction. Although it is acknowledged that participants who returned for the second discussion may have had more favorable experiences than those who did not, the preliminary data suggest that the female condom is acceptable to men and women at risk of HIV. HIV/AIDS prevention campaigns aimed at promoting female condom use should address the technical skills and knowledge of female anatomy needed for method use, empowerment and negotiation skills, and ways to eroticize female condom use.