Today begins a series of postings of abstracts presented at "AIDS 2006 - the 15th International AIDS Conference held in Toronto in August.
This Toronto abstract reminds us that after a new technology has been proven to be effective and accepted, it still needs champions to promote it. Is the Bill and Melinda Gates Foundation listening?
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Female condom programming experiences in Asia and the Pacific
WEPE0595
P. Weisenfeld1, C. Hong2, G. Stallworthy3, A. Murlidharan4, N. Sovann51The Female Health Foundation, Asia Regional Office, Chiang Mai, Thailand, 2PSI China, Kunming, China, 3PSI Myanmar, Yangon, Myanmar, 4PSI India, Mumbai, India, 5PSI Cambodia, Phnom Penh, Cambodia
Issues: - Despite their proven effectiveness, female condoms are currently underused and undervalued - Research provides evidence of effectiveness and acceptability; models indicate female condoms as a cost-effective intervention. - PSI program managers call for new ways to evaluate cost effectiveness based on programming experiences and assessments of female condoms as a "niche" product offering the only opportunity to achieve full potential in increasing incremental protection among selected user groups.
Description: In the concentrated epidemics in much of Asia/Pacific, female condoms have been marketed to groups with high HIV prevalence. This targeted approach has focused primarily on female sex workers. Experiences in the region indicate both user demand and programmatic effectiveness. Securing widespread support for scaling up remains a challenge - with gatekeepers (namely governments and donors) citing financial costs as the main barrier.
Lessons learned: 1. Taking female condom programmes to scale requires challenging current assumptions about cost effectiveness, e.g., identifying appropriate models for measuring cost per condom programmed. 2. Initial demonstration/research projects should be designed as operational research --with the intent to scale up - utilize a strategic approach (e.g. adaptation of the WHO strategic approach) with sufficient scale to document cost effectiveness. Donors and governments need to be committed to sustaining a program for 3-5 years prior to starting studies and demonstrations. 3. Niche products are important components of meeting the needs of high risk groups. Gender related inequalities and discrimination require products which increase the negotiating power of vulnerable groups.
Recommendations: 1. Female condoms should be a core component of prevention, care and support for high risk groups. 2. Additional research on large scale programs in Asia/Pacific would provider decision makers with a critical evidence base. 3. Female Condoms need champions with adequate resources for a global advocacy campaign. UNAIDS, WHO, UNFPA, the Global Fund etc should actively promote the full integration of female condoms.
