What Works for Women and Girls

8. Peer education for women can increase condom use.A randomized study in 2007 and 2008 with 737 married women (353 in the peer educationHIV intervention group; 384 in the control group) in rural North Anhui, Chinafound that peer education programs for married women increased condom use. Thepercentage of married women who used condoms in the past three months rose from4.5% to 21.5% in the intervention group, with no significant increase in the controlgroup (Hong et al., 2009). (Gray III) (condoms, marriage, China)9. Promoting pleasure in male and female condom use can increase the practice of safer sex.A literature review found that integrating elements of pleasure and the erotic into HIVprevention interventions could increase safer sexual practices and empower women tonegotiate safer sex. A meta-analysis (Scott-Sheldon and Johnson, 2006 cited in Knerr etal., 2009) found 21 studies measuring effectiveness of sexual risk reduction interventionsthat integrated a safer sex eroticization component and found that where eroticizationwas incorporated, participants showed significant risk reduction behavior incondom use; communication with sexual partners and a decrease in the number ofsexual partners. The meta-analysis included studies with randomized control trials orthose that had a quasi-experimental design. Of the 21 studies, one took place in Brazil,with the rest in North America and New Zealand. Erotic was defined as tending toarouse sexual desire or excitement. Literature from PubMed, Medline and IAC conferenceswas used from 2001 to 2007 for the review (Knerr et al., 2009). (Gray IV) (sexbehavior, Brazil, North America, New Zealand)Public health outcomes may benefit from adopting more positive views of safer sex.Citing grey literature and personal accounts of programs in Cambodia, Namibia, SouthAfrica, Senegal, Zimbabwe, Sri Lanka, Mongolia, India and the UK, the Pleasure Projectcontends that focusing on sexual pleasure—particularly eroticizing male and femalecondoms to increase use—can play a key role in the prevention of STIs/HIV (Philpottet al., 2006). (Gray V) (female condoms, sex behavior)In the Dominican Republic, one male client of a sex worker stated: “Campaigns aboutcondoms are really bad because they say condoms are to prevent pregnancy or diseasesbut that doesn’t motivate you to use condoms. What motivates you is information aboutwhat a condom is and why you use it, how you can feel when using it.” (Garcia et al.,2006: 59) (Gray V) (condoms, Dominican Republic)WHAT WORKS FOR WOMEN AND GIRLS61