Monday, November 1, 1999 Published at 16:19 GMT
Dinner with a femidom
So what do you do with this thing? (Photo: Center for Communications Programs)
The UN programme on Aids is trying to promote the use of female condoms as a way of preventing HIV transmission. But journalist Ticky Monekosso found that even well-educated African women remain ignorant of the potential of the femidom.
We were 12 women in a Chinese restaurant in Ferney-Voltaire, a French town just across the border from Geneva. Most of the women were from various countries in sub-Saharan Africa, members of an African women's association involved in Aids campaigning.
My dinner companions were married, mostly to UN international staff members, had lived abroad for more than five years and had studied at Western universities. The average age was about 30.
So they were an exceptional group of women. If they had problems with the female condoms, how much more severe would the problems be with ordinary women in Africa?
Yet only two women at our table were able to identify immediately what the 'plastic bag' was. One was a medical doctor and the other - a Ugandan - told me she had seen a femidom in a pharmacy in Geneva.
Something to do with sex?
Most of the women realised quickly that it was something to do with sex, but not with women's protection. Then we laughed a lot, imagining how to use it. Then, everybody became a little fearful, insecure, even confused. Was it really a female condom? The rings, what about the two rings?
It must be difficult to introduce into the vagina, said Josette. It would need care to use the condom hygienically, said Aminata, knowing the living conditions of women in Africa.
What about the "sexual negotiation" asked another. Persuading their husbands to accept the femidoms posed a problem for everyone.
The most important criticism was that the femidom was too easily visible. The women would have preferred something more discreet.
Then they asked about the price, its once-only use and why it is in a single packet and not in a packet of three or 12 like men's condoms.
Once, twice, three times?
Fatou suggested that the condom could probably be used several times with the same partner. But what about cleaning it? Horrible¡
I was left to inform the women that through grassroots social marketing networks, UNAIDS had managed to reduce the cost for public-sector distributors to just $0.62 per femidom - compared with a commercial price of $3.
And because it is strong, but expensive, the World Health Organisation said the product can be safely re-used up to five times, if washed carefully. So women tend to wash femidoms and re-use them, to minimise the cost of our self-protection - even when packet instructions warn against it.
"What about the movement? Have we got to hold it during intercourse? No, I can believe it; This is to give us cramp in our legs and hands", Said Fatou, seeing the pictures in the accompanying booklet. Some of the women felt a little deceived, even shocked.
"Please, don't laugh: it is a question on life or death," said Eva.
Someone else asked: "Please Ticky, tell them that we need better design for more discretion, safety, effectiveness and acceptability.
"We understand that it is an urgent matter and may need urgent research, but we need a better design to convince both the men and ourselves."
We also explored some of the results of UNAIDS studies on using the female condom in sub-Sahara African countries.
Stella said it was "incredible" that studies showed up to 95% of African men in favour of the use of female condoms.
"In Cameroon we cannot imagine any African man accepting these things," she said.
'Tool of negotiation'
On the other hand, said Olga, "even if the sexual story ends by using the male condom, it is important for us to have an alternative tool of sexual negotiation".
In Zimbabwe, South Africa and other few African countries where Femidom is available, the picture is different.
Women from those countries quickly realised that they needed to protect themselves in a cultural environment "where men do not think to put on socks before going out".