Female condoms: Many nurses not keen on promoting them
They are women's most effective contraceptive device, so why aren't far more using them?
Do you know whether a female condom can be used at the same time as a male condom?
And do you know whether the female condom removes sexual arousability?
The answer to both those questions is a definite no: You can’t use the male and female condom together, but sexual arousal won’t be hampered by the use of a female condom.Finding favour for the female condom
These were some of the questions put to nurses at 18 public healthcare facilities within the Johannesburg District for a study that revealed a worrying fact: while 79% of the nurses were knowledgeable about female condoms, only 59% were willing to promote them.The researchers, led by Magdelena Petkova from the Department of Family Medicine at the University of the Witwatersrand, point out why this is worrying.
“The female condom is the only current method for female partners to simultaneously prevent both pregnancy and sexually transmitted infections,” they say.
The study – published in the most recent edition of the South African Journal of Science – is part of a growing body of research on how providers’ attitudes towards contraceptive methods have an impact on whether their clients agree to use such methods.
This is the first study conducted in South Africa “on the knowledge of and willingness of healthcare providers to promote female condom use”, say the researchers, who concluded that “an effective strategy is needed to motivate healthcare workers to promote female condom use with their patients”.
The solution could lie in informal training of nurses within family planning units. Such training could improve both “their knowledge of and willingness to promote” female condom use.
Although South Africa performs well in terms of female condom uptake, we still have a way to go.
The South African female condom programme “is the largest and most comprehensive in the world”, and the use of female condoms has doubled since 2008.Emerging infectious diseases that could still hit SA
But, emerging infectious diseases like Ebola and Zika have made it all the more urgent to push the statistics up more.
“Recently other viral infections such as Ebola and Zika were found to be sexually transmitted. Despite the fact that cases of Ebola and Zika virus have never been reported in South Africa, the fact that these emerging infectious diseases could spread rapidly should be emphasised when promoting female condom use,” according to the researchers.It is considered to be more effective than the male condom because it is less likely to break or burst and it covers a larger portion of the genital area.
Considering those positives, and since it’s the only barrier to both pregnancy and sexually transmitted infections that a woman can have full agency over, why isn’t it more popular?
The researchers say the low acceptability of female condoms is possibly “interpersonal factors” and its “higher cost”.
The researchers concluded that “these worrying finding indicate that it is necessary to have effective mechanisms to increase not only knowledge on female condom use, but also motivation in healthcare providers to promote such use”.
They said that the low level of willingness has serious implications for reducing the spread of HIV and other STIs such as Ebola, Zika and hepatitis B.How’s your own knowledge compared to the nurses?
Now that you know that female and male condoms can’t be used together, and that the female condom does not hamper male arousal, you can test your knowledge further in the same way that the nurses were tested. True or false:
Female condoms do not prevent pregnancy and sexually transmitted infections.
The female condom cannot be put in place eight hours before intercourse.
The female condom has a flexible ring at the closed end of the pouch with a slightly larger ring at the open end.
At the open end of the sheath, the ring stays inside the vagina just around the cervix.
If your answer to the first question is true, you’re wrong. Female condoms absolutely do prevent pregnancy and sexually transmitted infections. The majority of the nurses knew this answer.
If your answer to the second question is false, you’re wrong again. A female condom can be inserted up to eight hours before sexual intercourse. A “significant number of nurses demonstrated adequate knowledge” on this point.
Now to the more technical questions: if you said true for question three, you’re on the money. The female condom does indeed have a flexible ring at the closed end of the pouch with a slightly larger ring at the open end. A majority of the nurses had “adequate knowledge” about this.For question four – “at the open end of the sheath, the ring stays inside the vagina just around the cervix” – the answer is false, but this was answered correctly by only 28% of the nurses.
This is a technical question and can only be correctly understood by participants who had received training, according to the researchers.
More than half of the participants did not know whether “a female condom can be used simultaneously with a male condom” while the vast majority (just over 90%) knew that it doesn’t affect arousal.
•Other researchers on the paper included: Zuberu Elabor (a physician in Port Elizabeth), Trayana Djarova-Daniels (University of KZN), Emilia Pavlova (National Sports Academy, Bugaria) and Olufemi Omole (also from Wits University)...