227057 Provider HIV and pregnancy prevention practices in southern Africa: The female condom

Monday, November 8, 2010 : 1:24 PM - 1:42 PM

Cynthia C. Harper, PhD , Bixby Center for Global Reproductive Health, Department of Obstetrics, Gynecology & Reproductive Sciences, University of California, San Francisco, San Francisco, CA
Tsungai Chipato, MD , Department of Obstetrics and Gynecology, University of Zimbabwe, Harare, Zimbabwe
Tzadzaa Nhemachena, MD , School of Medicine, University of Zimbabwe, Harare, Zimbabwe
Maya Blum, MPH , Center for Reproductive Health Research & Policy, University of California, San Francisco, San Francisco, CA
Neetha Morar, PhD , HIV Prevention Unit, Medical Research Council, Durban, South Africa
Charles McCulloch, PhD , Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA
Gita Ramjee, PhD , HIV Prevention Unit, Medical Research Council, Durban, South Africa
Kelly Blanchard, MS , Ibis Reproductive Health, Cambridge, MA
HIV prevalence is high in southern Africa, as is infection among young women. The female condom is currently the only female method for HIV/STI and pregnancy prevention, and this study assesses provider practices. We conducted national, probability surveys of physicians and nurses providing family planning and HIV/STI prevention services in South Africa and Zimbabwe (n = 1,452). We asked providers about their contraceptive and HIV/STI care. Virtually all providers surveyed care for low-income patients, adolescents, women needing contraception, at-risk and HIV-positive patients. Eighty percent usually discuss pregnancy and HIV/STI prevention at the same visit. Most (90%) offer their patients female condoms (99% for male condoms). Ninety-two percent consider the female condom to be an appropriate contraceptive for women at high risk of HIV, while very few consider the highly effective contraceptives (e.g. pill, IUD, implant), apart from injectible, as appropriate. Views were similar for HIV-positive women. Providers rate as high the need for female barrier methods, as well as methods that can be used discreetly by women. Results of trials on female barriers have been discouraging (i.e. microbicides, diaphragm), but a new, less expensive female condom, FC2, was recently approved for USAID distribution. The female condom leaves certain needs unaddressed, such as discreet use by women or coital-independence, but has advantages too: it is already recognized by providers and integrated into practices. Providers reported they would welcome an improved female barrier method. Distribution of supplies should quickly follow approval, to address HIV and pregnancy prevention needs.

Learning Areas:
Provision of health care to the public
Public health or related research
Social and behavioral sciences

Learning Objectives:
1. Describe current female barrier methods available to women in southern Africa. 2. Explain the importance of the female condom for HIV/STI and pregnancy prevention. 3. Identify the shortcomings of this female barrier method.

Keywords: Contraception, HIV/AIDS

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am the PI on the NIH study we are reporting data on and am responsible for study design, data collection, analysis and interpretation. I am on the faculty of a medical school and primarily conduct research.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.