Introducing the female condom to drug users in Brazil

Brazil is currently the number two country in the world for reported cases of AIDS, and the rate of heterosexually acquired cases is on the rise. Moreover, because of the changing focus of the epidemic, the ratio of male to female cases dropped from 28 : 1 in 1984 to 2.7 : 1 in 1997. While women's risk of infection continues to grow, there is evidence to suggest that traditional approaches to HIV risk reduction have not effectively addressed women's special needs. Within such a setting this study sought to introduce drug-involved women to the female condom – a female-controlled method of protection from HIV. As part of a larger HIV/AIDS intervention study targeting low-income, cocaine users, the primary aim of this initiative was to assess the level of acceptability of this new device among women at high-risk for HIV infection in Rio de Janeiro, Brazil. In conjunction with individual pre-test HIV prevention counseling, clients participated in a detailed education/demonstration session with the female condom. Women were asked to try the female condom with their partners and to report their experiences at two points of contact. Outcome data indicate that a sizable proportion (71.1%) of the sexually active women used the female condom during vaginal sex on one or more occasions. In addition, many women continued to use the female condom as a method of risk reduction over the three-month follow-up period. These data suggest that the female condom can have an important role in HIV prevention efforts in Brazil.