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Query: UMLS:C0019693 (HIV)
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The female condom is a thin, lubricated, 6.8 inch long polyurethane sheath with plastic rings at both the closed and open ends. It is designed to be inserted into the vagina before and while having sexual intercourse to afford protection against unwanted pregnancy and the transmission of sexually transmitted diseases. Female Health Co. of Chicago, illinois, is the US manufacturer of the female condom. The United Nations program against AIDS announced July 15, 1997, having made a deal with Female Health Co. to sell the condom in developing countries for approximately one dollar, less than half the normal market price. About 10 developing countries, including South Africa, Brazil, and Thailand, have already placed orders for the condom and about 30 more are interested. The anticipated availability of the female condom in these developing countries means that for the first time women in such male-dominated societies will be able to protect themselves against pregnancy and HIV even if their partners refuse to wear condoms. A woman can even insert the female condom into her vagina hours before having sex.
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PMID:UNAIDS promotes female condoms in developing countries. 1232 Sep 66

The female condom is a disposable, lubricated, polyurethane sheath designed to be inserted into the vagina before and while having sexual intercourse to afford protection against unwanted pregnancy and the transmission of sexually transmitted diseases. Population Services International (PSI), on behalf of the National AIDS Coordination Program and the Zimbabwe National Family Planning Council, has launched the condom in Zimbabwe under the brand name Care. The arrival of the female condom has been welcomed by both the country's health authorities and women's groups. Data from the National AIDS Coordination Program indicate that more than 1 million of Zimbabwe's 12.4 million people are infected with HIV. The Ministry of Health and Child Welfare reports that 500 people die each week of AIDS-related illnesses. 8 of 10 HIV-infected women contracted the virus through unprotected sexual intercourse. Women, who generally must rely upon their partners' willingness to use condoms, are up to four times more vulnerable to HIV infection through sexual intercourse than are men. Encouraging research conducted in Zimbabwe in early 1997 determined that 56% of men and 50% of women interviewed were interested in using the female condom. They will initially be available only in pharmacies in Harare, Bulawayo, and Chitungwiza at the introductory price of approximately US$0.27 per box of two. The government has also secured funding to procure approximately 400,000 female condoms for free distribution through public health institutions.
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PMID:Female condom launched in Zimbabwe. 1232 Sep 67

Femshield, a new barrier contraceptive device for women, is expected to be on the market throughout the world within the next year. Developed and manufactured by Medicor Limited, it consists of a soft loose-fitting polyurethane sac about 15 cm long and 7 cm in diameter. Attached at its open end is a flexible outer polyurethane ring which covers the vulva with a 2nd flexible inner ring to aid insertion and retention. Sexual intercourse takes place, with a good lubricant, within the cavity of the device. Medical-grade polyurethane was selected since it is better suited to the purpose of lining the whole vagina than latex rubber. Femshield is expected to offer protection of the same order as the condom against both pregnancy and the viral sexually-transmitted diseases such as hepatitis B and Human Immunodeficiency Virus. In a pilot study at the Margaret Pyke Centre for Family Planning in London, a majority of both sexes reported Femshield to be as acceptable or better than the condom; most previous diaphragm users also preferred the new device. A definite minority rejected Femshield at least in its present form. Some modifications can be expected before marketing. Femshield will be sold at a price competitive with the price of condoms. It will be subject to stringent quality testing, and it will come in packaging with clear instructions.
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PMID:A new IUD. 1234 60

Perinatal or vertical transmission, the transmission of HIV from mother to child, is common as the epidemic spreads in central Africa, but less so than epidemiologists had predicted. In Uganda about 10% of AIDS cases are due to vertical transmission; in Rwanda 35% of all AIDS cases were in children; in Kenya, however, only 30% of children of infected mothers developed AIDS. HIV can spread to a child via the placenta during pregnancy, the vagina during birth, or breast milk after delivery. Although there is evidence of all 3 routes of spread, the likelihood of transmission by breast milk is low, and WHO recommends that children be breast feed even if their mothers are HIV positive. It is difficult to test for transmission of HIV in newborns because the usual tests for HIV antibodies will pick up immunity passed from mother to child during pregnancy, which may last up to 12 months. Despite the fact that perinatal transmission of HIV was lower than expected, in a study in Uganda, infant mortality was high, 15% in children of HIV positive mothers, compared to 2% in controls. On the other hand, surviving children did respond effectively to childhood immunizations.
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PMID:Robbing the cradle. 1234 22

The African Research and Educational Puppetry Program, founded in 1987, produced "Puppets Against Aids." The 20-minute play about Joe and Mary, workshops available, audience response, and the impact of the show are described. The story centers on Joe, who has many sexual encounters without the protection of condoms. He contracts HIV infection and transmits it to his wife Mary, who transmits it to her unborn baby. Scenes portray Joe receiving the news from his doctor, and Mary and Harry as a friend caring for the dying Joe. The scenes reflect compassion for the sick and debunk fears of casual contact as a means of HIV transmission. There are 2 sizes of puppets, hand puppets and puppets 2m tall. The hand puppets require just a puppeteer, musician, or technician and narrator, which makes traveling with the show easier. The faces of puppets are grey to depict the universality of the disease. The narrator tells the story along with background music. A condom demonstration is given and literature is distributed after the performance. A question and answer (Q and A) period is provided. Before entering a village or area, information is collected on the nature of the community and on any sensitivity to words or issues e.g., in Zimbabwe, the Shona are offended by words such as penis or vagina, and kutsu (down there) is substituted. In open-air situations, a megaphone announces the show. At schools, teachers may be asked to leave the room in order to provide greater privacy in the the Q and A period. Performance are appropriate to the population served. At the main center in Johannesburg, South Africa and during tours, workshops of 1-5 days are offered on basic AIDS education, education skills, script writing, puppetry techniques, and animation exercises. There is a strong commitment to using respected community organizations to transmit information. Audiences are videotaped and interviews are sometimes conducted after the show. Problems are revealed and solutions found. Evaluations of effectiveness are being made and results suggest that audiences like the theatricality, the music and dancing, the information, and the condom demonstrations. The puppets have been effective in crossing racial and cultural barriers in nonthreatening ways.
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PMID:Puppets against AIDS: breaking through racial and cultural barriers. 1234 89

Women are biologically more susceptible to HIV infection than men through heterosexual penile-vaginal intercourse, and transmission by heterosexual means seems to be increasing. The use of male condoms and partner reduction are currently recommended to reduce the risk of contracting and transmitting HIV. Women can, however, only indirectly influence these behaviors. Many face social and emotional factors which make it impossible to negotiate condom use with an unwilling partner. Scientists are therefore paying greater attention to female barrier methods such as the female condom and spermicides as potential female- controlled ways to help women avoid infection. Noncontraceptive chemical methods in the form of jellies and topical creams are being explored. Limited in vivo scientific data exists on how these methods may prevent the transmission of HIV. The female condom is a thin, plastic sheath which covers the cervix, vagina, and women's external genitalia. It has gone to clinical trials in 1700 women at 71 sites. While many women are in favor of the method, objections to its use have been voiced due to its appearance, the noise made during intercourse, slippage, how it feels during intercourse, expense, reduced sensitivity, and embarrassment. Its potential for re-use must be explored. Only inconclusive results are available on the effectiveness of spermicides. While lab and animal research show nonoxynol-9 can kill HIV, it remains to be seen how much or how often it may be used before mucosal linings become irritated and potentially facilitate the entry of HIV. Many unresolved questions about the mechanics of HIV infection remain to be answered before these methods may be fully endorsed by a wide array of scientists.
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PMID:Seeking HIV prevention strategies for women. 1234 82

A diaphragm is a dome-shaped soft rubber cup with a flexible rim which when correctly fitted and inserted into the vagina of a woman protects her from unwanted pregnancy and some sexually transmitted diseases. Its ability to prevent the male-female transmission of HIV, however, is unknown. Available with the prescription of an health care provider who will ensure that the correct size is provided, diaphragms cover the cervix and are held securely in place behind the pubic bone and the rear wall of the vagina, thus preventing pregnancy by blocking the entry of sperm into the cervical canal. The device also holds a spermicidal jelly or cream which kills sperm which may manage to swim around the rim of the diaphragm. A diaphragm may be inserted up to six hours before intercourse and must be used at each coitus to prevent pregnancy. The woman should urinate and wash her hands before inserting the diaphragm. A limited amount of spermicide should then be placed in the cup and around the edge of the device. The woman then holds the diaphragm dome facing down, presses the opposite sides of the rim together between the thumb and third finger, and pushes it in as far as it will go along the rear wall of the vagina until it is locked in place just above the pubic bone. During insertion, the woman may stand with one leg up, squat, or lie down with legs flexed as she sees fit. The diaphragm should then be left in the vagina for at least six hours after intercourse and removed soon thereafter. Simply tug behind the front rim with one's index finger to remove the device. The diaphragm is then washed with mild soap and water, and stored in a cool, dry place until next use.
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PMID:How to use the diaphragm. 1234 30

According to the Panos report, the male-to-female ratio of HIV cases in North America is 7 to 1, twice the rate of ten years ago. In the Caribbean, the ratio of HIV infections is now almost equal between men and women. In Latin America, infections among women are on the rise and in sub-Saharan Africa, where the transmission of HIV is overwhelmingly heterosexual, more women than men are infected. As more women become HIV-positive, the number of infections in their babies also rises. The simple fact of being married can raise the risk of infection among women, because infidelity is more commonly accepted among men than women. Women cannot always persuade their partners to use condoms, nor do they always have the option of refusing sex. To overcome the problem of noncooperative men, current research is focusing on female-controlled HIV prevention methods, such as female condoms or virus-killing spermicides. The US-based Population Council is also exploring the possibility of developing a virucide or microbicide which could be inserted into the vagina to protect against HIV transmission, while allowing sperm to pass unharmed. However, a product is not likely to appear on the market in the near future. Because there is no immediate prospect of an HIV vaccine or cure, HIV prevention should continue to focus on getting people to change their sexual behavior.
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PMID:Women's issues. Worldwide they face greatest HIV risk. 1234 6

Women of the Laobe ethnic group and the Dimba, a traditional women's association, provide advice about sexuality and reproductive health in southern Senegal. Research was initiated in October 1992 by the Cheikh Anta Diop University to determine whether these women could also help in HIV/AIDS and STD prevention activities. The study investigated men's and women's knowledge, attitudes, beliefs, and practices (KABP) related to sexuality and HIV/AIDS/STDs in the community of Kolda; practices potentially increasing women's risk of HIV/STD infection; and possibilities for integrating HIV/STD prevention messages into the interactions which take place between the Laobe and Dimba groups and the Kolda community. The KABP study was a questionnaire administered to 250 men and 250 women of reproductive age representing five ethnic groups residing in Kolda. 11 men and 14 women older than age 40 participated in in-depth sexual life history interviews. The survey and interviews indicate that people in Kolda do not generally see a link between sexual relations and STD transmission. Instead, STDs are attributed to behaviors such as urinating, walking barefoot on the urine of an already-infected person, encountering a "bad wind", and being cursed. Women may be at increased risk of HIV infection through practices designed to enhance sexual pleasure, including the insertion of organic and mineral product into the vagina, and the cutting of bumps and warts in and around the vagina. Sexual practices, knowledge, prevention through the Laobe and Dimba, and outcome and follow-up are discussed.
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PMID:Traditional women's associations as channels for HIV / AIDS / STD prevention. 1234 70

According to the Health Ministry's National AIDS Coordination Program (NACP), 48,882 people died due to AIDS between 1987 and September 1995. 21,099 of these individuals were women. Many men have unprotected sex with multiple partners, contract HIV, then transmit it to their primary sex partner. Any given wife may know that she is not her husband's only sex partner, but her options to protect herself against potential HIV infection are extremely limited. Although there is some indication that the level of condom use has increased, some men still refuse to wear them. It is considered unacceptable for women to refuse the sexual advances of their husbands. At the same time, wives tend to be economically dependent upon their men and have little alternative to marriage for survival. Even among financially independent women, divorce or separation from their husbands is not an option, for society frowns upon women who leave their marriages. Women who are thus trapped in a marriage with a promiscuous, noncontracepting husband need some means to protect themselves against HIV/STD when having sex. Femidom, an oversized polyurethane condom which women can insert into the vagina to serve the same protective and contraceptive function as the standard male condom, may be just what these women need. Women do not need the man's consent to use Femidom, and reports suggest that men often do not even realize that the device is in place when having sex. Before the marketing of Femidom may begin, however, the government must register it. Officials argue that Femidom is too expensive and that it cannot be made available until it is clearly proved effective. Critics counter that the government subsidizes many other family planning devices.
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PMID:Zimbabwe women "don't have the means to protect themselves". 1234 21


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