The female condom is polyurethane sheath or pouch about 17 cm (6.5 inches) in length. A woman wears it during sex. It entirely lines the vagina and it helps to prevent pregnancy and sexually transmitted diseases (STDs) including HIV.

At each end of the condom there is a flexible ring. At the closed end of the sheath, the flexible ring is inserted into the vagina to hold the female condom in place. At the other open end of the sheath, the ring stays outside the vulva at the entrance to the vagina. This ring acts as a guide during penetration and it also stops the sheath bunching up inside the vagina.

There is silicone-based lubricant on the inside of the condom, but additional lubrication can be used. The condom does not contain spermicide. The female condom should not be used at the same time as a latex male condom because the friction between the two condoms may cause the condoms to break.

The female condom has been available in Europe since 1992 and the US Food and Drug Administration (FDA) approved it in 1993. It is available in many countries, at least in limited quantities, throughout the world. The female condom carries various brand names in different countries including, FC Female Condom, Reality, Femidom, (brand which will be available in the Turks and Caicos Islands) Dominique, Femy, Myfemy, Protectiv' and Care.

What are the benefits?

• Opportunity for women to share the responsibility for the condoms with their partners
• A woman can use the female condom if her partner refuses to use the male condom
• The polyurethane, the material the female condom is made of, is less likely to cause an allergic reaction than a male latex condom. It is not clear whether latex or polyurethane condoms are stronger - there are studies suggesting that either is less likely to break. With both types, however, the likelihood of breakage is very small, if used correctly.
• The female condom will protect against most STDs and pregnancy if used correctly
• It can be inserted up to 8 hours before intercourse so it does not interfere with the moment
• The polyurethane is thin and conducts heat well so sensation is preserved
• The female condom can be used with oil-based lubricants. The male condom can only be used with water-based lubricants.
• No special storage requirements are needed because polyurethane is not affected by changes in temperature and dampness, like the male condom. The expiry date for female condoms is 5 years from the date of manufacture.
• What are the disadvantages?
• The outer ring is visible outside the vagina, which can make some women feel self-conscious
• The female condom can make noises during intercourse. Adding more lubricant can help this problem.
• Some women find the female condom hard to insert and to remove
• It has a higher failure rate in preventing pregnancy than non-barrier methods such as the pill
• It is relatively expensive and relatively limited in availability in some countries
• It is recommended that the female condom is only used once

Can I reuse the female condom? It is believed that limited availability and high cost have led some women to reuse female condoms in some countries. The World Health Organization (WHO) recommends use of a new male or female condom for every act of intercourse for those people who use condoms for pregnancy prevention and/or STI/HIV.

Support for the female condom WHO and UNAIDS are encouraging the introduction of the female condom as a new method of preventing both pregnancy and infection and as an additional tool in efforts to respond to the needs of women and men in sexual and reproductive health. The female condom is also effective part of the solution in prevention of HIV/AIDS/STD in high prevalence areas. Worldwide use and availability.

The female condom is widely used in countries that actively promote its use, such as South Africa, Ghana and Zimbabwe. However in other countries, such as the USA, it isn't as popular. The female condom is available on a limited basis in the Turks and Caicos Islands and we are currently making plans to again introduce and promote this method as an accepted and available form of protection. A few years ago a six month thrust was made to introduce the female condom but its use was very limited and not enough was done in terms of evaluating its introduction or issues that would have hampered or helped its use by sexually active women.

In the past few years however with the growing incidence of HIV among women and the need for more women to be empowered to protect themselves the female condom has become a tool that can help with this. It will take time to get use to its use. At our first attempt the women who helped to pilot its use, did not like the squishy sound it made and some felt it was difficult to put on, some of the women who attended the workshops complained about the 'ugliness of the condom as well. Despite this those who used the condom were happy that they had something they could control, especially when the male partner insisted on not using condoms.

When introduced the female condoms will be available at the nation's clinics and in a few selected distribution outlets across the islands. You can call the National AIDS Program for more information on its use. Cherylann Sanderson Jones.

National AIDS Program Coordinator