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Female condom breaks gender barriers - India - A case study

Presented by Manoj Gopalakrishnan, India.

B. Gaddi1, K. Potturi2, M. Gopalakrishnan3, M. Agarwal4, E. Bayliss5, Female Sex Workers

1Hindustan Latex Family PLanning Promotion Trust, Program Manager, Hyderabad, India, 2Hindustan Latex Family PLanning Promotion Trust, National Program Manager, Hyderabad, India, 3Hindustan Latex Family Planning Promotion Trust, CEO, Delhi, India, 4NACO, JD IEC, Delhi, India, 5Female Health Foundation, Asia - Advisor, Cambodia, Cambodia

Issues: Women are disproportionately affected by HIV. Non-consensual sex, fear of violence, economic dependence and the inability to negotiate condom use, restrict prevention options for women. Abstinence and monogamy are inadequate defences for women who often marry young and are deprived of education and social status. Female Condom (FC) addresses all these.
Description: Hindustan Latex Family Planning Promotion Trust (HLFPPT, India) in collaboration with National AIDS Control Organisation (NACO) and UNFPA conducted a pre-programme study in 61 NGOs across eight states reaching out to 80000 women. NACO procured 500,000 FCs to be social marketed for this study.
Integrating FC into mainstream HIV prevention programs, creating an enabling environment for FC introduction and addressing gaps in condom usage with regular partners and drunken clients have been key challenges addressed by the FC program.
Key program activities included capacity building of communities; social marketing through peer educators; BCC workshops; advocacy with media, police, pimps and madams; and monitoring at the community level.
Lessons learned: Community participation in the promotion of female initiated preventive methods had a direct impact on the product acceptance. 76% of the women said that FC empowers them. This empowerment has helped the women address the gender inequities with their partners.
The program led to behavior change, evident from the fall in number of unsafe sex acts from 5.1% to 2% over a period of six months; rise in client acceptance; 90% of FSWs reporting ease in use; increase in number of FSWs using FC from 6000 to 18000; and increase in number of FSWs repurchasing FCs from 20% to 60%.
Next steps:
• Programme scale-up across India covering high risk women, PLHIV, women at workplaces and integration into RCH programme.
• Linkages with the upcoming female initiated prevention technologies and their introduction in India, like the microbicides.

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