What Works for Women and Girls

Gaps in Programming—Male and Female Condom Use1. Condom promotion aimed at serodiscordant couples, particularly those in long-term,stable relationships is needed.2. Interventions are needed to increase condom access by women, especially in ruralareas.3. Interventions are urgently needed to provide greater availability and access to femalecondoms, along with education and training regarding their use as an alternative tomale-controlled male condoms.4. Providers and VCT counselors need training on female condoms to promote use.1. Condom promotion aimed at serodiscordant couples, particularly those in long-term, stablerelationships is needed. Studies found that counselors and serodiscordant couples did notunderstand that the HIV-negative partner could acquire HIV, even after many years andHIV-positive women reported that their husbands refused to use condoms.Gap noted, for example, in five African countries (Desgrées-du-Loû and Orne-Gliemann,2008); Uganda (Bunnell et al., 2005); Thailand (Yoddumnern-Attig et al., 2004).2. Interventions are needed to increase condom access by women, especially in rural areas. Astudy found fewer condom outlets and access in rural areas.Gap noted, for example, in Kenya (Papo et al., 2008).3. Interventions that are tailored to specific groups of women are urgently needed to providegreater availability and access to female condoms, along with education and trainingregarding their use as an additional option to male-controlled male condoms. Studiesfound that women felt that they could avoid conflict and enhance their safe sex bargainingpower by using a female condom when their sexual partner refused to use a male condom.Gap noted, for example, in Kenya (Brady et al., 2009); Brazil (Dias et al., 2006); SouthAfrica (Mqhayi et al., 2003 cited in Mantell et al., 2005); Uganda (Green et al., 2001);generally (Hoffman et al., 2004; Green et al., 2001; Okunlola et al., 2006; Mathews andHarrison, 2006).4. Providers and VCT counselors need training on female condoms to promote use. Studiesfound that providers and counselors need training in order to be able to promote femalecondom use.Gap noted, for example, in Kenya, (Mung’ala et al., 2006); South Africa, the US, andNigeria (Mantell et al., 2001).62 CHAPTER 3 PREVENTION FOR WOMEN