Moore Lizzie, Beksinska Mags, Rumphs Alnecia, Festin Mario, Gollub Erica L
MatCH Research (Maternal, Adolescent and Child Health Research), Department of Obstetrics and Gynaecology, University of the Witwatersrand, Westville, Durban, South Africa.
Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK.
Open Access J Contracept. 2015 Sep 21;6:125-142. doi: 10.2147/OAJC.S55041. eCollection 2015.
Women in developing countries are at high risk of HIV, sexually transmitted infections, and unplanned pregnancy. The female condom (FC) is an effective dual protective method regarded as a tool for woman's empowerment, yet supply and uptake are limited. Numerous individual, socioeconomic, and cultural factors influence uptake of new contraceptive methods. We reviewed studies of FC knowledge, attitudes, practices, and behaviors across developing countries, as well as available country-level survey data, in order to identify overarching trends and themes. High acceptability was documented in studies conducted in diverse settings among male and female FC users, with FCs frequently compared favorably to male condoms. Furthermore, FC introduction has been shown to increase the proportion of "protected" sex acts in study populations, by offering couples additional choice. However, available national survey data showed low uptake with no strong association with method awareness, as well as inconsistent patterns of use between countries. We identified a large number of method attributes and contextual factors influencing FC use/nonuse, most of which were perceived both positively and negatively by different groups and between settings. Male partner objection was the most pervasive factor preventing initial and continued use. Importantly, most problems could be overcome with practice and adequate support. These findings demonstrate the importance of accounting for contextual factors impacting demand in FC programming at a local level. Ongoing access to counseling for initial FC users and adopters is likely to play a critical role in successful introduction.
发展中国家的女性面临感染艾滋病毒、性传播感染和意外怀孕的高风险。女用避孕套是一种有效的双重保护方法，被视为增强妇女权能的工具，但供应和使用情况有限。许多个人、社会经济和文化因素会影响新避孕方法的采用。我们回顾了发展中国家有关女用避孕套知识、态度、实践和行为的研究，以及现有的国家层面调查数据，以便确定总体趋势和主题。在不同环境中针对使用女用避孕套的男性和女性开展的研究表明，女用避孕套的接受度很高，人们经常将其与男用避孕套相比较，而且评价更佳。此外，研究表明，引入女用避孕套可增加研究人群中 “受保护” 性行为的比例，为伴侣提供了更多选择。然而，现有的国家调查数据显示，女用避孕套的使用率较低，与对该方法的认知没有强烈关联，而且各国的使用模式也不一致。我们确定了大量影响女用避孕套使用与否的方法属性和背景因素，其中大多数在不同群体和不同环境中都有积极和消极的看法。男性伴侣的反对是阻止开始使用和持续使用女用避孕套的最普遍因素。重要的是，大多数问题可以通过实践和充分的支持来克服。这些发现表明，在地方层面的女用避孕套项目规划中，考虑影响需求的背景因素非常重要。为初次使用和采用女用避孕套的人持续提供咨询服务可能对成功引入该产品起到关键作用。
