by Kat Kelley
On November 29th, 2012, Hillary Clinton commemorated World AIDS Day by releasing The President’s Emergency Plan for AIDS Relief (PEPFAR) Blueprint: Creating an AIDS-free Generation. The United States is the largest donor in the fight against the global HIV/AIDS pandemic, accounting for 59.2% of funding worldwide (1). Thus, PEPFAR’s Blueprint, a roadmap for the U.S. government’s goal of achieving an “AIDS-free generation,” is not just another memo. The Blueprint will be instrumental in shaping the fight against HIV/AIDS in the coming years.
Within the Blueprint, a number of strategies are detailed. The four main components of health care provision are as follows: preventing mother to child transmission and HIV related maternal mortality, increasing coverage of HIV treatment, increasing rates of voluntary medical male circumcision, and increasing access to and utilization of HIV testing and counseling and prevention methods including condoms.
Throughout the article, female condoms are frequently cited alongside male condoms. The Blueprint also goes on to say that the female condom is “unique,” as a “female-controlled HIV prevention option,” and that its promotion will be an “essential part of an overall condom strategy” (2). In 2009, female condoms comprised a mere 3.2% of total U.S. condom shipments (3)- so why are they now being referred to as an “essential” part of U.S. condom strategy and the fight against HIV/AIDS?
Globally, women represent 52% of those living with HIV(4), and 60% of those living with HIV in Sub Saharan Africa (5). And these infections are not restricted to high risk populations. In developing countries, 3/4 of HIV infections are transmitted through heterosexual intercourse, and the majority of new infections in women occur within marriage or long-term relationships. Young married women are currently the fastest growing HIV positive population (6). This phenomenon is the result of gender inequalities and the subjugation of women and girls in these countries. While men frequently have extramarital relations, often with commercial sex workers, their partners or wives do not have the power to negotiate safe sex.
Female condoms are the only female-initiated dual protection tool- the only tool that both prevents pregnancy and the spread of STIs. They give women greater control over whether or not protection is used. Female condoms can be inserted several hours in advance, and can remain in after ejaculation, giving women the ability to protect themselves in anticipation of undesired or potentially unprotected sex. Female condoms can be used when a male partner is not erect due to the effects of drugs or alcohol. Case-studies in several Sub-Saharan African countries indicate that women are often able to use a female condom when a man has refused to put on a male condom.
However, don’t underestimate the female condom- this isn’t just a tool for development. A recent study by economist David Holtgrave indicated that the D.C. Department of Health’s female condom promotion program- which included distribution, marketing, education and training, managed to be cost-saving (antiretrovirals aren’t exactly a bargain…) Plus, female condoms are perfect for whiskey dick (#college) and preliminary case studies are indicating increased pleasure, when compared to the use of male condoms.
If we want an AIDS-free generation, we must engage women and address the unique needs and disadvantages they face globally.
P.S. For more information check out the Center for Health and Gender Equity’s Prevention Now Campaign.
P.S. Look out for haters- the Female Health Company’s FC2 is a game changer. This recent model seems to have all the kinks worked out.
(1) “Financing the Response to AIDS in Low- and Middle- Income Countries: International Assistance from Donor Governments in 2011,” The Henry J. Kaiser Family Foundation (2011). http://www.kff.org/hivaids/upload/7347-08.pdf.
(2) “PEPFAR Blueprint: Creating an AIDS-free Generation,” The President’s Emergency Plan For AIDS Relief (2012). http://www.pepfar.gov/documents/organization/201386.pdf.
(3) “Female Condoms and U.S. Foreign Assistance: An Unfinished Imperative for Women’s Health,” Center for Health and Gender Equity (2011). http://www.genderhealth.org/files/uploads/prevention_now/publications/unfinishedimperative.pdf.
(4) VISION, UNAIDS, “UNAIDS report on the global AIDS epidemic 2010.”
(5) “Global Fact Sheet: World AIDS Day 2012,” UNAIDS (2012). http://www.unaids.org/en/media/unaids/contentassets/documents/epidemiology/2012/gr2012/20121120_FactSheet_Global_en.pdf.
(6) Barbara C. Shane et al., “Female condom: a powerful tool for protection,” UNFPA, PATH (2006).