KENYA: HIV-positive and still sexy
http://www.plusnews.org/PrintReport.aspx?ReportId=75357

Photo: Zanzibar International Film Festival "You can have your sexuality...you don't have to lose it because you have HIV"

MOMBASA, 16 November 2007 (PlusNews) - People tend to think that contracting HIV can spell the end of their sex lives, but HIV-positive Africans of all ages are now being urged to reclaim their sexuality and live healthy, normal lives.

"I got this [HIV] through sex, so [I thought] my sexuality was gone and I felt I needed to stop dressing attractively and wait to die," Florence Anam, 28, an information officer at the Kenya Network of Women with AIDS, told IRIN/PlusNews.

Anam said when she first revealed she was HIV-positive, many men avoided her, believing she was out to infect them; she herself had no interest in sex for several months after she was diagnosed. However, she has since discovered she can continue having and enjoying sex, despite being HIV-positive.

"My take on this is that you can have your sexuality ... you don't have to lose it because you have HIV, you just have to be responsible," she said, adding that sex "has to be good or I'm not having it".

At a recent workshop by the Africa Regional Sexuality Resource Centre (ARSRC), at its Sexuality Institute in Kenya's coastal city of Mombasa, participants heard that there was a need to rethink sexuality in the context of disease, particularly chronic infections such as HIV.

"HIV as a condition is highly moralised; people face stigma because they are perceived by society to have been sexually immoral," said Richmond Tiemoko, director of ARSRC.

"Women are particularly affected by this type of stigma because they are expected to be the keepers of society's morality, so contracting HIV is seen as a great failure on their part." He said it was important that people living with HIV recognised and claimed their right to sexuality and sexual intercourse.

The Sexuality Institute provides a forum for African health professionals to discuss ways of promoting more positive attitudes towards sexuality in the region.

"We believe that to reduce HIV and promote well-being, we need to adopt a positive discourse on sex and sexuality," said Tiemoko. "Discussing issues of sexual violence, stigma, self-esteem and HIV enables people to have a better understanding of their links with sexuality and to make them less taboo."

I am a human being with sexual needs and feelings, which need fulfilment without apologies to anyone. The workshop was attended by researchers, government workers and staff from local non-governmental organisations with a reproductive health or AIDS focus. They were encouraged to incorporate messages about healthy sexuality into their programmes for people living with HIV.

"When first diagnosed, I considered sex dirty and blamed it for my fate," Asunta Wagura, executive director of the Kenya Network of Women with AIDS, said in a recent interview with the Sexuality in Africa magazine, an ARSRC publication. "I suppressed this need for a long time, until I could suppress it no more and openly declared, 'I am a human being with sexual needs and feelings, which need fulfilment without apologies to anyone'."

Wagura, who has publicly declared her HIV status, caused controversy when she decided to have a child in 2006. Her son was born healthy and has so far tested HIV-negative.

"I was criticised all round ... the view is that people living with HIV/AIDS should not think along those lines, because having a baby involves sexual intercourse," she said.

Speaking at the workshop, Dr Sylvia Tamale, dean of law at Uganda's Makerere University, said there was a 'disconnect' between sex in a health or medical context, and sex in a pleasure context.

"There is a need to 'unlearn' and refine some of the lessons that society teaches us, and open people's minds," she said, adding that sexuality counselling could go a long way towards changing perceptions.

The ARSRC holds rotating workshops annually in Egypt, Kenya, Nigeria and South Africa. The Mombasa workshop was hosted in conjunction with their partner organisation in Kenya, the Population Council, an international non-governmental reproductive health organisation.

kr/he

See also, Florence Anam: "HIV hasn't stopped me from enjoying sex"and, South Africa: Positive Prevention Themes: (IRIN) HIV/AIDS (PlusNews), (IRIN) PWAs/ASOs - PlusNews
[ENDS] Report can be found online at:
http://www.plusnews.org/report.aspx?ReportId=75357

A Time to Rethink AIDS’s Grip http://www.nytimes.com/2007/11/25/weekinreview/25mcneil.html?ref=science
IN THE STORM An HIV support group walks past an AIDS ribbon in Lesotho, Africa, in 2005. By DONALD G. McNEIL Jr.

Published: November 25, 2007IGNORE the fuss over the news last week — the United Nations’ AIDS-fighting agency admits to overestimating the global epidemic by six million people. That was a sampling error, an epidemiologist’s Dewey Defeats Truman.

Look instead at the fact that glares out from the Orwellian but necessary revision of the figures for earlier years. There it is, starkly: AIDS has peaked.

New infections reached a high point in the late 1990’s — by the best estimate, in 1998.

There must have been such moments in the past — perhaps A.D. 543, when Constantinople realized it would survive the Plague of Justinian, or 1351 in medieval Europe, when hope dawned that the Black Death would not claw down everyone.

Eleven years ago, there was a milestone moment in AIDS history when Andrew Sullivan wrote an article in The New York Times Magazine titled “When Plagues End.” It argued that a new treatment, the triple therapy cocktail, meant it was finally possible to envision AIDS as a chronic illness, not an inevitable death sentence.

Naturally, he was, in his words, “flayed alive” by the AIDS establishment. An end in sight implied that vigilance could relax — although he hadn’t actually argued that.

Mr. Sullivan’s view was solipsistic. It celebrated hope for gay American men still reveling in their sexual freedom and barely mentioned the wider reality of newborn babies and faithful wives in Africa who were never to enjoy any freedoms and still were doomed to die miserably in numbers that would blast the exit doors off every gay bar in North America.

Now, out of the mists of the old data, another such moment has emerged, one for the worldwide stage.

The first thing experts are again quick to say is that it doesn’t mean anyone can relax.
More than three million annual new infections in 1998, or an estimated 2.5 million for 2007, “is not a particularly happy plateau,” said Dr. Robert Gallo, a discoverer of the AIDS virus.

Dr. Mark R. Dybul, the Bush administration’s global AIDS coordinator, added: “I don’t think it radically shifts our thinking, at least not for 5 to 10 years. We still need to prevent 2.5 million infections, we still need to prevent 2.1 million a year from dying.”

Nonetheless, the disease is at last giving notice that it will behave like other pestilences.
AIDS has always been maddening. It moves more slowly than anything that rides sneezes or coughs or rats or mosquitoes. It permits years of symptom-free infectivity and kills, like a torturer, at its leisure.

Classically, all epidemics first strike down those in the vanguard: the Genoese merchants who fled the siege of Caffa in 1347, bringing plague to Europe; the conquistadors who “discovered” syphilis in the New World. If an avian flu pandemic emerges, it will be among poultry farmers and kindergarten teachers, who both herd flocks of little vectors. In gay America, it was flight attendants and rent boys.

Then epidemics typically surge into pockets where conditions are perfect: ports teeming with rats; populations weakened by famine; flooded Bengali streets; Thai brothels.

Finally, inevitably, they begin to burn out. Hosts die faster than new hosts can be found. And, crucially, the hosts get smarter. They flee cities, drain swamps, invent vaccines or accept self-restraint and condoms.

Until now, AIDS had defied that paradigm. Its dark spiral seemed to just keep widening — central Africa was worse than America, southern Africa was worse than that, India would be worse, China was next

But it now appears that the burnout has been underway for years.

In the year 2000, I wrote an article for this section trying to calculate how much it would cost to contain global AIDS, which was said to infect 30 million people in poor countries. (Last week’s revision drops that closer to 23 million.)

Officials of Unaids, the United Nations’ agency, declined to be quoted saying so at the time, but in their policy decisions, they had written off all who were already infected.

The agency was seeking $2 billion a year for Africa — simply for prevention. Triple therapy cost $12,000 a year per patient. Cipla Ltd., the Indian generic-drug maker, had not yet offered to supply the drugs for $350, which set prices tumbling; they are now $150. The Global Fund to Fight AIDS, Tuberculosis and Malaria did not exist.

Undoubtedly, virtually all of those 23 million are now dead. Even now, most could not be saved — antiretroviral drugs reach only about one-tenth of those who need them.

But now we know that those falling legions were right at the cusp of the epidemic. Albeit imperceptibly at the time, things were improving. The sight of so many skeletons had scared a lot of Africans into changing their habits.

It’s still not clear why southern Africa was hit the hardest. There are theories — migratory mine labor, less circumcision, perhaps a still-undiscovered genetic susceptibility.

But the southern Africa explosion has not repeated itself as the virus moved on into Asia’s much greater populations. It has hit very susceptible pockets, like the red light district of Calcutta, but seems to have stalled in them.

“In the 90’s,” said Dr. Paul De Lay, director of monitoring and policy for Unaids, “we thought that if you had the crude signs that risky sex was going on, like brothels or refusal of condoms, then any country could erupt into a generalized epidemic. That’s not true any more. Now we’d never say China is likely to have an African-style epidemic.”

This does not mean that shrinking numbers are inevitable.

The disease is still rooting out new pockets; infections are rising in Vietnam, Uzbekistan and even Indonesia, the world’s fourth-most-populous country.

It can also lull its hosts into acting foolishly again; that has happened in San Francisco and Germany, Dr. De Lay noted, where new infections are ticking up again as young gay men revive the bar scene of the 1980’s.

And, Dr. Gallo warned, a mutation — a virus more easily transmitted or more drug resistant — could emerge. Epidemics traditionally move in waves; that could trigger a second.

Nonetheless, the new estimates mean the vision Mr. Sullivan had of the American epidemic is now possible for the global one: a day when AIDS is viewed as a chronic problem, another viral predator taking down the careless or weak members of the herd, as pneumonia takes down the old ones.

Also possible in the future — the very distant future, Dr. Dybul warned — is a day when the calculation I tried to do will have an answer that is actually affordable.

After all, even the Black Death is not dead. But it is cornered, and very cheaply. Its cause, Yersinia pestis, lives on in fleas and rodents, and there are about 2,000 cases each year, a handful of them in the American Southwest. But penicillin kills it.

Nothing yet kills AIDS. When that day comes, another rewrite of the epidemic’s history will begin.

A Bush Double-Cross on HIV Travel Ban
http://www.gaycitynews.com/site/news.cfm?newsid=19044628&BRD=2729&PAG=461&dept_id=568864&rfi=6

By: DOUG IRELAND
11/20/2007

President George W. Bush and Homeland Security Secretary Michael Chertoff, under the guise of cutting read tape, are doing so to use that tape to further tie up prospective HIV-positive visitors and immigrants to the US.

The Bush administration is trying to pull a fast one rushing through draconian proposed new regulations that will restrict even further the entry of HIV-positive people into to the US, just one year after having promised to ease them. On November 6, the Department of Homeland Security (DHS) issued stringent proposed new regulations for HIV-positive travelers coming here which are pretty regressive and extremely troubling, according to Nancy Ordover, assistant director for federal affairs and research at the Gay Mens Health Crisis (GMHC). But the 30-day deadline for public comment imposed by DHS means a cut-off date of December 6 for reactions to the new regs, leaving little time for the AIDS advocacy community to mobilize. That, Ordover told Gay City News, is a departure from standard practice for proposed new federal regulations; the time frame for public reaction is usually much longer, she said.

The US is one of only 13 countries that completely ban incoming travel across their borders by the HIV-positive. The others, according to a list established by the leading German AIDS service organization, Deutsche AIDS Hillfe, for the most part have undemocratic regimes. They are Iraq, China, Saudi Arabia, Libya, Sudan, Qatar, Brunei, Oman, Moldova, Russia, Armenia, and South Korea. A waiver to the ban is required for HIV-positive travelers to or through the US. Even when a travelers US stay merely involves changing planes, a waiver is needed. Last year on World AIDS Day, President George W. Bush pledged to issue streamlined new regulations with a categorical waiver that would make it easier for the HIV-positive to receive exemptions. Unfortunately, despite using the terms streamlined and categorical, in reality these regulations are neither, said Victoria Neilson, legal director of Immigration Equality, which works on behalf of LGBT and HIV-positive asylum seekers and immigrants. Neilson told Gay City News, This is a big disappointment, given the rhetoric of the Bush administration that the US was making it easier because the new regs simply add more heavy burdens for the HIV-positive traveler. Among other provisions, under the new rules proposed by DHS, a visitor would need to travel with all the medication he would need during his stay in the US; prove that he has medical insurance that is accepted in the US and would cover any medical contingency; and prove that he wont engage in behavior that might put the American public at risk. The maximum term for any waiver would be 30 days. The new regulations purport to speed up the waiver application process because consular officers would be empowered to make decisions without seeking DHS sign-off. However, by using this streamlined application process, waiver applicants would have to agree to give up the ability to apply for any change in status while in the US, including applying for legal permanent residence. The purpose of fast-tracking the new regs and setting a super-tight December 6 deadline for public comment before they take effect was to catch the AIDS community busy with preparations for World AIDS Day on December 1 unawares. To a certain extent, the ploy has worked. When Gay City News telephoned the usually well-informed Kate Krauss who has worked for several AIDS advocacy organizations and now coordinates the Health Action AIDS Campaign for Physicians for Human Rights to find out what she thought of the proposed new regs, she hadnt yet heard of them. Wow, they just flew right by me they havent been on my radar screen at all, she said. After having been provided by Gay City News with a copy of the proposal, Krauss was appalled. Under the proposed regulations, the US travel ban remains a cruel violation of human rights for people with AIDS, Krauss said, adding, People with HIV would be made to jump through even more hoops than before, and the rules would make it particularly difficult for people from very poor nations to visit the US, with requirements for wealth, medical care, medications, and documentation that the applicant is HIV-positive. Moreover, Krauss said, People could be penalized if they became sick while visiting the United States and, if found to be out of compliance with these regulations, barred from ever visiting the US again. If President Bush cares about the human rights of people with AIDS, he should just ask Congress to abolish the travel ban. Anything else is just rewriting an unjust policy. GMHCs Ordover pointed out, As written, the rule could leave individuals with HIV who obtain asylum in the US in a permanent limbo; forever barred from obtaining legal permanent residence, and therefore cut off from services, benefits, and employment opportunities. Ordover added, It seems very disingenuous that the government is claiming to make things easier for people with HIV, but its really compelling them to forfeit their rights. As a result of the hasty release of the proposed regs and the arbitrarily truncated time frame for public comment, only a few AIDS advocacy organizations have so far taken a critical posture, and this only began to happen at the end of last week. GMHC was the first organization to release a lengthy analysis of the new regs, which it did last Friday, and began preparing a sign-on statement protesting them which it will ask other AIDS advocacy groups and immigrant rights organizations to join. But things were fairly sluggish at AIDS Action Council, the largest Washington, DC AIDS lobby, which bills itself as the national voice on AIDS and represents more than 3,000 local service organizations. When Gay City News this Monday asked Ronald Johnson, AIDS Actions deputy executive director, for his organizations position on the new regs, he would only say, we are in the process of developing our comments and we are still looking at the fine print. Johnson added, Well probably follow GMHCs analysis. When this reporter suggested to Johnson that AIDS Action organize a national conference call with executive directors of AIDS advocacy organizations to mobilize them quickly against the harsh new regs, he said theyd think about it. Fortunately, GMHC is already in the process of organizing such a conference call for next week, Ordover told Gay City News. However, said Ordover, these regulations are in general a distraction what we really need to move forward on is getting the HIV-positive travel bar overturned completely. In addition to her other duties at GHMC, Ordover is co-coordinator of Lift the Bar, a coalition of HIV, immigrant, human rights, and LGBT service and advocacy organizations working to overturn the HIV ban. At a Congressional hearing last November, Ordover detailed the negative consequences of the travel ban. The HIV bar rarely makes the news, and when we do hear about it, its usually because someone trying to attend some major event or forum being held in the US cant get into the country, Ordover said. This is not unimportant the International AIDS Conference hasnt been held on US soil for 16 years and the HIV bar is the reason. Despite our efforts in the global fight against HIV and AIDS, our standing in the international community has been grievously compromised by this policy. Ordover, who noted that one-third of GMHCs clients are immigrants, also pointed out, Many people first learn they are HIV-positive after they get to the US. Many contract HIV here. Some find out their status when they get the results of their Immigration Service medical examination. Under the current DHS regs in force, she said, Visitors either are actively deterred from seeking HIV testing and treatment, or avoid contact with providers out of fear of putting their immigration status in permanent limbo or worse. If they are low-income or poor, they either dont have recourse to the full slate of public programs and services they need to stay healthy or may be unaware of what services they are entitled to. At GMHC we view this policy as a violation of human rights and a threat to public health inside and outside the US. The proposed new regs do nothing to change this. And, Ordover added, The truth is, the bar undermines public health and drives up the cost of health care. It forces HIV-positive immigrants to go underground, discourages immigrants who dont know their status from getting tested, from seeking preventive care, from seeking any care until they end up in the emergency room with full blown AIDS all things that undermine individual health, public health and that ultimately put more strain on the public coffers.

Individuals who wish to protest the harsh new DHS regs on HIV-positive travel may submit comments online at click - but to do so you must include the docket number of the proposed regs, USCBP-2007-0084. Organizations wishing to join in signing on to the statement GMHC is preparing in protest of the new regs should contact Nancy Ordover at nancyo@gmhc.org or 212-367-1240. Doug Ireland can be reached through his blog, DIRELAND, at click.

GayCityNews 2007

Early Puberty in Girls May Reflect Home Life
Findings Suggest Link Between Family Stress, Early Sexual Development
http://www.abcnews.go.com/Health/ReproductiveHealth/story?id=3871218&page=1

New research suggests that for girls, a hostile home environment could have physical, as well as psychological, effects. (ABCNEWS) By DAN CHILDS
ABC News Medical Unit
Nov. 15, 2007

While a stressful family environment in childhood has long been blamed for various psychological effects later in life, new research suggests that hostile situations at home may also have big physical implications for young girls.

In a study released Thursday, researchers at the University of Arizona and the University of Wisconsin-Madison looked at families of 227 preschool children, following them as they progressed through middle school. Specifically, the researchers looked for the first hormonal signs of puberty in these children.

What they found was that parental support -- or lack of it -- may partially determine at what age young girls hit puberty. Specifically, young girls with families who were more supportive in preschool years tended to hit puberty later than their counterparts in less supportive family environments.

The research stops short of drawing a bold link between early stress and early puberty, as factors such as family income and other environmental factors may also be at play. But lead study author Bruce Ellis said that while it is still too early for parents to make solid conclusions based on the evidence, the findings hint at an interesting evolutionary link between sexual maturation and stress.

"Children adjust their development to match the environments in which they live," said Ellis, an associate professor in the Division of Family Studies and Human Development at the University of Arizona in Tucson.

"Children who grow up in environments that are dangerous and unpredictable tend to grow up faster," he said. "In the world in which humans evolved, danger and uncertainty meant a shorter lifespan, and going into puberty earlier in this context increased chances of surviving, reproducing and passing on your genes."

Julia Graber, associate professor of psychology at the University of Florida in Gainesville, said the study adds to a growing body of evidence linking early stress with the onset of puberty.
"It's an interesting topic, there has really been a lot of research coming out recently on this particular issue," said Graber, who was not affiliated with the research.

But she agreed with Ellis that too many unanswered questions still exist for definite conclusions to be drawn.

"As yet, there is no clear idea of why stress factors work in this way."

Consequences of Early Development

If one thing is certain, it is that early sexual development in girls is often a signal for other health consequences.

Past research has already shown, for example, that early puberty in girls increases the risk of various health problems, both physical and psychological.

"In today's world, early puberty in girls is a risk for many things, such as breast cancer, teenage pregnancy and depression," Ellis said. "Effective prevention strategies depend on understanding the factors that speed up puberty."

Graber said girls may be more susceptible to such environmental factors for the simple reason that, evolutionarily speaking, bearing children successfully goes hand-in-hand with favorable environmental conditions. Hence, she said, the female system is programmed to be more responsive to environmental cues.

Still, Graber added, the concept of stress leading to early puberty is in some ways puzzling.
"The body needs to be healthy in order to be pregnant, and stress seems to impact health negatively," she said. "What we're seeing is something that doesn't really fit in terms of what we'd expect."

Advice for Parents

So what should parents take away from this research? Ellis, for one, urged caution in overinterpreting the results.

"There are too many unanswered questions to translate this into a blueprint for parents," Ellis said.

But while Graber agreed that the findings are preliminary, they suggest that parents should take special care to ensure a nurturing environment for their children early on.

"The message for parents is that a stressful home environment really does impact children in many detrimental ways," she said.

"There will always be some minor conflicts between parents and children, but parents don't need to worry if there is still that warm, close relationship even as occasional issues come up.

But if these children are really in a stressful environment, it is really affecting their health."

Female condoms: Shifting the burden of safe sex to women? http://www.infochangeindia.org/features457.jsp
By Rashme Sehgal
Hindustan Latex is all set to market the female condom, particularly to sex workers. NACO is partnering with 61 NGOs across six states to reach out to 60,000 female sex workers. Sex workers in Hyderabad, where the condom was tested, say it gives them a sense of control over their bodies The onus of responsibility for safe sexual behaviour has now shifted squarely onto the shoulders of women. NACO (National Aids Control Organisation) and the Hindustan Latex Family Planning Promotion Trust (HLFPPT) have joined hands to promote the female condom as an alternative to the male condom, especially since there are innumerable cases being cited by housewives, sex workers and single women of male partners refusing to use condoms.

Hindustan Latex Ltd (HLL), a State-owned condom manufacturing company, is all set to market a female condom called ‘Confidom passion rings’. The 17 cm female condom is the same size as a male condom, but two flexible rings at both ends give it the appearance of a “basketball net”. That is how it was described by a sex worker in Hyderabad, who when she first saw it complained that the polyurethane condom with its large, lubricated pouch that is fixed to the vagina seemed much “too big and unwieldy”. Once the women were shown how it worked, however, they realised that it was not as difficult to use as it appeared.

Sex workers in Hyderabad, amongst whom the female condom was extensively tested, know that using it is their safest bet to prevent getting HIV/AIDS or sexually transmitted infections (STIs). Lakshmiamma, a sex worker, feels safe when she uses a female condom. “There are no more needless arguments with clients about using condoms. I have just learnt to protect myself,” she says.

In 2006, HLFPPT, the Chicago-based Female Health Company (FHC) and NACO carried out a social acceptability study on the use of condoms in Andhra Pradesh, Kerala and Maharashtra, among three sets of target groups namely female sex workers, men who have sex with men (MSM) and eligible couples. The total sample size of users was 717, of which 337 were female sex workers.

The objective of the study, which was spread over a period of two months in 2006, was to analyse perceptions and initial acceptability of the female condom in terms of efficacy, reliability and ease of use. It was important also to identify enabling factors affecting initiation and negotiation, and to find out whether the condom helped foster communication between partners.

Some sex workers who were part of the sample study spoke candidly about their experiences with the female condom.

Pushpamma, who works in the old city of Hyderabad, pointed out that she was happy to use it because it helped protect her from HIV/AIDS. She said: “The main reason for using a female condom is disease-prevention rather than as a means of contraception.”

Rosy, another sex worker, felt the female condom has several features in its favour. “Some clients felt its lubrication helped enhance pleasure. It also provided an effective barrier against drunken clients who refused to use condoms.”

Married women responded in much the same way. The female condom, they said, was an alternative when their husbands refused to use condoms. But a Delhi-based teacher felt that the large size of the condom and the hardness of its inner ring caused too much discomfort during insertion.

Kavita Patturi, NACO’s national programme manager, admits that use of the female condom between eligible couples dropped from 94% to 89% during the final week of the survey, while for MSM it dropped to 94% in the eighth week. Problems cited in using it included its large size, slippery nature, and the fact that privacy was required in order to insert it.

“Regular and timely counselling on potential problems is a must in order to ensure regular usage,” says Patturi who admits that wherever outreach workers were able to provide effective interventions, barriers such as discomfort and pain were easily overcome.

But the majority of women covered under the study said they were willing to use the product as it was seen as being woman-initiated and would lead to their empowerment. Many MSM had even switched to the female condom because of its reliability. Unlike the male condom, it does not tear easily, thereby increasing safety.

G Manoj, CEO of the Hindustan Latex Family Planning Promotion Trust, says: “Women have to be taught how to use it. Demonstrations on its use were first conducted on vagina moulds by outreach workers associated with different NGOs working in the area of HIV/AIDS. Female condoms can succeed only as part of a social marketing campaign, not if they are sold as mere condoms. This has been the experience around the globe.”

The female condom does have its drawbacks however. It requires time and privacy to insert, and these are not always available to a sex worker. But Jayamma, who has helped 1,500 sex workers come together to form a Hyderabad-based cooperative called Chaitanya Mahila Mandal, says: “Prior to the female condom we used to be stigmatised for spreading HIV. That situation has now changed.” A government study has shown that 14% of India’s 5.1 million HIV-positive people are sex workers; female condoms are aimed specifically at them.

Female condoms were introduced in India after two years of research and test-marketing. Confidoms are being given to NGOs for Rs 3; they are then sold to sex workers for Rs 5. Although the price is higher than that of a male condom, female respondents of the survey said they did not mind spending more because of its reliability.

Jayamma said: “If we can spend money every day on biryani and a gajra, we can also spend on a female condom.”

Patturi says NACO is partnering with 61 NGOs across six states in order to reach out to 60,000 female sex workers. NGOs with whom partnerships have been forged include SAATHI, Sapid, Vimochana, Changes, Jawahar, KAWW, RCTC, SARANG, Sex Workers Forum, Saheli, Sambhavan, Udaan, Vijay Krida Mandal and Yuvak Pratishtan. “So far we have not come across a single case of a customer rejecting a sex worker because she is using a female condom,” Patturi points out.

The female condom is not expected to replace the male condom. Presently, the male condom programme in India extends to over 1.5 billion male condoms. NACO imported 500,000 female condoms in 2006; the figure has gone up to 1.5-2 million pieces in 2007-08.

“We would like to adopt a cafeteria approach to contraception, with the male and female condoms playing complementary roles,” says Manoj.

The Indian market holds the key to the success of the female condom. HLL is presently in talks with FHC for transfer of technology to indigenise production of the female condom to help bring down the retail price.

Infochange News & Features, November 2007