The female condom

WHAT IS THE FEMALE CONDOM?

The female condom is a woman-initiated family planning method that also protects women from HIV and other STIs. It has no side effects. Studies report a high satisfaction rate by both women and men who have used the female condom. The potential for increased use of the female condom and its positive impact on public health is therefore substantial. Despite the fact that the female condom has been in production for 15 years already, it is not widely available for an affordable price yet.

• fighting the increase of infections of HIV/AIDS amongst women and girls
• reducing the high number of unwanted pregnancies
• avoiding the high costs and limited availability of AIDS treatment

Female condom

Description
The female condom is a condom that is inserted into the woman’s vagina. It is made of a soft, thin material and fits loosely inside a woman’s vagina. Like the male condom, the female condom is a barrier method, keeping the penis from contact with the cervix, the vagina, and parts of the external female genitalia and containing the sperm in the condom preventing contact with the vagina.  So the female condom offers protection against both unintended pregnancy and sexually transmitted infections, including HIV.
Current models on the market, have a flexible ring or sponge at the closed end of the condom that is used to insert the device and helps to keep the condom in place during sex. A ring/frame at the open end of the condom stays outside the vagina, lies flat across the genital area and ensures the condom stays in place.
The female condom can be inserted into the vagina prior to sexual intercourse, it is not dependent on a male erection, and can remain in place after ejaculation. It has no known side-effects or risks and can be used by women of all ages.
The first female condom (FC1) was made from poly-urethane, a thin odourless material that is stronger than natural rubber latex, conducts heat, is hypoallergenic,  and comes with silicone based lubricants. FC1 is on the market since 1992.
Since 2006, different types of female condoms have become available. New models are made from latex and synthetic latex (nitrile). These were designed to improve affordability, particularly in larger volumes, while maintaining the same high quality, reliability and safety as the original female condom. The latex female condom (the Reddy female condom) comes lubricated with silicone oil but can also be used with other water based lubricants. The nitrile female condom also comes with silicone based lubricants. The use of extra lubricants depends on the type of Female Condom. Follow the instructions on the package. 
The WHO has published guidelines on reuse (2002) of female condoms, however, does not recommend the reuse of female condoms. WHO recommends that women should use a new female condom for every act of sex where there is risk of unplanned pregnancy or sexually transmitted infections, including HIV.
A key product under development is PATH’s woman’s condom, which has a dissolving tampon-like capsule for easier insertion, dots of foam to keep the poly-urethane condom in position in the vagina, a flexible outer ring, and a separate lubricant. It is planned to be available in China in 2010. The Mediteam company in Belgium is at a very  early stage of development of a latex female condom, which resembles a looser female condom with a soft flat collar.

Efficacy
Female condoms work on the same principles as male condoms, however, as male condoms have been available for a long time, most of the testing how well condoms work has been conducted on male latex condoms and they have been found to be effective in blocking HIV and STI pathogens. Female condoms are highly effective in preventing pregnancy. Estimates of its contraceptive efficacy are within the range of other barrier protective methods (e.g., male condoms); over the course of one year, the accidental pregnancy rate ranges from 15 to 25 percent for actual use to as low as 5 percent for correct use with every act of intercourse. FC maintains lower failure rates than the cervical cap and diaphragm.
Female condoms also provide significant protection from STIs. In vitro studies confirm that female condoms are an effective barrier against many common STIs, including HIV. Calculations based on correct and consistent use estimate a 97. percent reduction in the risk of HIV infection for each act of intercourse. 
Results from research interventions in Brazil, India, Thailand, the United States, and Zambia indicate an increase of protected sexual acts and decrease in STI prevalence when female condoms are available alongside male condoms. In a pilot study from Thailand, protected sexual acts increased from 57 to 88 percent, and STI prevalence decreased from 52 to 40 percent when both male and female condoms were available.
Female condoms are the only female-initiated methods of HIV prevention that are safe and effective. Studies from 40 countries show acceptability rates ranging from 37 to 93 percent.