Put a Ring on It!

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The Women's Health Activist
March/April 2012

By Keely Monroe

Cities around the country are making sure that more women stay healthy and sexy by telling them to “put a ring on it”! What type of ring, you may ask? We aren’t talking about the kind Beyoncé warned men they better give their ladies or get kicked to the curb; we’re talking about the new and improved female condom. 
 
What makes the female condom so sexy?
 
The female condom is a strong, thin pouch with one closed end and one open end. A flexible polyurethane ring at the closed end of the pouch is inserted into the vagina, while a soft synthetic ring at the open end remains outside the vagina. 
 
Female condoms are currently the only self-initiated barrier method option women have for preventing unwanted pregnancies and transmission of sexually transmitted infections (STIs), including HIV — which makes them a critically important prevention tool for women. The number of women infected with HIV is rising dramatically, driven, in part, by women’s difficulties in negotiating consistent condom use by their male partners. In 1985, women made up just 8 percent of all new U.S. HIV infections; by 2009, women comprised 25 percent of new HIV infections. The statistics are even more alarming for women of color. Black women are 23 times more likely, and Latinas are 5 times more likely, to contract HIV than are White women. In the U.S., heterosexual transmission is the cause of the vast majority (84%) of women’s HIV infections. These facts make finding and promoting tools to protect women against HIV/STI transmission a critical priority. 
 
The Network has always been committed to ensuring that every woman has self-determination in all aspects of her reproductive and sexual health — and the female condom furthers this ideal. It is an essential component of women’s reproductive health toolbox because it provides a unique and important benefit that both empowers and protects women. As one woman puts it, “Using the female condom makes me feel in control.”  That, to us, is SEXY.  
 
A shaky start 
 
Despite being available in the U.S. since 1988, the female condom is neither a well-known nor popular prevention method. The Female Health Company, which makes the female condom, acknowledges that the product originally flopped in the U.S. market due to its high cost and the lack of any program to introduce women to the method. To address these problems, the company developed a second-generation female condom, called “FC2”, which it released in October 2009.
 
In contrast to the original female condom, which was made of expensive polyurethane, FC2 is made from synthetic nitrile, a less expensive material. The change in materials lowered the price, eliminating the significant cost barrier that prevented many women from using the original female condom. In addition, to inform women about the method and its benefits, the Female Health Company has partnered with health advocates to spread the word about FC2 throughout communities with high rates of HIV/AIDS.
 
Female condoms get a second chance at fame
 
Advocates have always known that female condoms have the potential to play an important role in promoting positive sexual health and preventing HIV and other STIs. But, they also know a lot of work was needed to overcome the original female condom’s bad reputation. International experience showed that, when women had a chance to learn about the product from trained educators who gave them tips on what to expect and how to make it work well, they embraced female condoms whole-heartedly. In Zimbabwe, after hair stylists in 500 salons were trained to educate women and demonstrate the FC2’s correct use, the number of women who reported using the female condom almost doubled: increasing from 15 to 28 percent from 2002 to 2004. 
 
So, when the FC2 was released in the U.S. in 2008, advocates grabbed the opportunity to gain new momentum in promoting the female condom. With funding from city and state health departments and from private philanthropic sources, five cities with high HIV/AIDS prevalence have launched creative and fun public education campaigns, drawing on lessons learned in other countries, to engage communities and increase both awareness and use. These cities are Chicago, Houston, New York City, San Francisco, Washington DC. Campaigns are also scheduled for Atlanta and Baton Rouge. 
 
Drawing on leadership from both the public and private sectors, these cities are using attention-getting public awareness campaigns and community education programs to train educators in the best ways to introduce female condoms to inexperienced users. Their efforts are modeled after campaigns in other countries, which have been successful, resulting in increased female condom use and, hopefully, reduced HIV/STI transmission.  In New York City, over 3,200 individuals were trained in condom educational sessions and more than one million FC2s distributed in 2010, an increase of six percent over the number distributed in 2009.  The city also increased visibility and access by creating a smart phone “app” that allows users to find nearby venues that distribute free safer sex products. 
 
Chicago has been using well-known pop culture to make female condoms exciting.  The catchy and familiar slogan, “Put a Ring on It” gave educators a fun way to start the conversation and also garnered local, national, and international press for the female condom movement.  Those of you in our nation’s capital may have seen buses passing by with FC2 advertisements telling DC to “Get Turned On To It.” The city is also facilitating FC2 distribution at nail salons, barber shops, and health clinics.  Houston’s campaign, launched less than a year ago, is focusing on social media presence and ensuring increased access across the city.      
 
San Francisco launched its “Our Bodies, Our Choices” campaign on Valentine’s Day 2011; the campaign targeted women, men who have sex with men, and transgender individuals, and highlighted the FC2’s versatility. Although not specifically approved by the Food and Drug Administration (FDA) for anal sex, preliminary research indicates that using a female condom during anal sex helps prevent HIV/STIs.  FC2 is filling a critical unmet need as the only prevention tool that the receptive partner can use.  Jessica Terlikowski, of Chicago’s Female Condom Campaign notes: “That ability and that power is not something that can be underestimated.”  
 
Be part of the movement
 
Are you inspired to join the sexy female condom movement?  If you live in one of these cities, visit their campaign websites to find out how you can become involved:
 
Or, start a campaign in your own city!  Contact Jessica Terlikowski, National Female Condom Coalition coordinator, at JTerlikowski@aidschicago.org to find out more. 
 
Although the female condom may not have superstar rank among contraceptive methods yet, with innovative and engaging campaigns taking place around the country, it seems inevitable that female condoms will eventually reach the famed status they deserve! 
 
Keely Monroe is an NWHN Program Coordinator