Understanding Female Condom Use and Negotiation among Young Women in Cape Town, South Africa Open Access

Martin, Julia Ellen (2015)

Permanent URL: https://etd.library.emory.edu/concern/etds/d217qp58s?locale=en


Background In many countries, female condoms are not well known. Uptake has been slow outside of communities targeted for promotion. Brazil and South Africa are exceptions; knowledge and prevalence of female condoms are relatively high. South Africa has the fourth highest HIV prevalence in the world and was chosen as the site for this study focusing on how women and men successfully introduce female condoms and negotiate their use.

Methods The study tooka qualitative approach and conducted 27 in-depth interviews with men and women who had used female condoms in two Cape Town sites. Two primary research questions were asked: how do women negotiate female condom use, and how do male partners negotiate or respond to negotiations of female condom use? Thematic analysis was used to identify key patterns in the data.

Results Participants discussed barriers to female condom use, differences between male and female condoms, education issues, and partners' reactions to female condom negotiations. Participants evidenced that female condom use was easier for women to negotiate than male condoms, largely because this method was understood to be under a woman's control. The main discomfort participants described with female condoms was related to unfamiliarity and lack of education. Personal comfort issues and tensions with partners usually resolved following the first use of the female condom.

Discussion These findings shed positive light on the potential for increased female condom education and distribution. Unfamiliarity hindered use, however this study found little evidence that negative partner reactions hindered use. There is little doubt that female condom availability empowers women to initiate barrier method use in various circumstances, and especially where male condom use might be refused. Results suggest a few key improvements in program efforts; female condom programming should be directed toward men as well as women, and toward couples who go for couples testing. Education should include a discussion on gender dynamics and responsibility. Finally, comprehensive female condom education is as important as increased availability, and improved training for providers and educators is likely a critical first step in the process.

Table of Contents

I. Introduction. 1

II. Background. 3

III. Methods. 9

IV. Results. 14

V. Discussion. 24

VI. Appendices. 30

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