As activists and policy makers debate what creates sufficient access and what does not, I went out to the streets of Johannesburg to get the views of ordinary South African women on the female condom: Have they used it? If not, why have they not used it?

‘€œNo, I have never used it’€, said one Soweto teenager.

‘€œI haven’€™t used it yet. I don’€™t even know how it looks like’€, said another.

‘€œYes, I have used it before. I found it quite user-friendly’€, a woman in her mid-twenties told me.      

‘€œThe female condom is so uncomfortable. You have to use your fingers to insert it and in the process you hurt yourself’€, said another one, disapproving.

‘€œOh yes, I have definitely used it! It is so good! Moreover, after use, it’€™s easily removable’€, another remarked enthusiastically.

‘€œAs for me, I don’€™t see what its purpose is’€, said another.

This exercise gathered varied responses ‘€“ both positive and negative. But, activists still argue that female condoms must be distributed widely to encourage acceptability and allow women to make choices in the way they want to protect themselves against sexually transmitted infections (STIs), including HIV, and unplanned pregnancy.

‘€œUniversal access to the female condom is definitely a human rights issue. In September 2008, at a national dialogue it was confirmed by the South African Human Rights Commission (SAHRC) as well as sections of the United Nations (UN) that the lack of adequate access to affordable female condoms in this country is a human rights violation’€, argues Tian Johnson, Operations Manager for the Thohoyandou Victim Empowerment Program (TVEP).

South Africa has a five-year National Strategic Plan (NSP) on HIV/AIDS which aims to halve the number of new HIV infections by the year 2011. Currently, 1  400 people are infected daily in the country. The plan contains provisions for the allocation and purchasing of 425 million male condoms and a meagre three million female condoms annually.

Asked whether the inadequate access to female condoms is a challenge unique to South Africa, he replied:

‘€œWe are unique in terms of lack of political will with regards to the sexual and reproductive rights of women in this country. South Africa is one of a few African countries who have a comprehensive NSP that looks at mitigating the impact of HIV/AIDS. We’€™ve just passed the mid-term review of the NSP and the three million female condoms have not yet been bought’€.

Dr Samukelo Dube, Africa Director of the Global Campaign for Microbicides is another advocate for universal access to female condoms. She says the government ‘€œhas a moral and constitutional responsibility to control the spread of HIV’€.

‘€œGovernment should actually look into this matter very closely, since government has the obligation to look after its citizens. The female condom is a technology and tool that will help government reduce the incidence of HIV’€, Dube said.

Activists say the female condom is not only a commodity that offers women protection against STIs and unwanted pregnancies, but it also affords them an opportunity to exercise control and alternative methods of prevention.

‘€œWomen indeed have rights to make decisions over sexual matters. They should be able to say, ‘€˜oh baby, you don’€™t feel like using a male condom, let’€™s use a female condom. It is available’€™. So, the female condom is as equally vital as the male condom’€, says Zonke Mabude, Researcher and Director in the Durban Research Cluster of the Reproductive Health and HIV Research Unit.

Up until now, their cost has been the reason why they are not easily accessible. Female condoms cost more per unit to produce because they are made from polyurethane materials compared to male condoms which are manufactured using latex material.

But the TVEP’€™s Johnson says the government should consider that it’€™s cheaper to buy female condoms than to care for someone who is already infected with HIV.  

‘€œIf you look at the cost of the subsequent care that the public health system has to provide to an HIV-positive patient versus the cost of the female condom, the answer is clear.   It’€™s an investment that we have to make. Cost should not be used as a barrier to ensuring the sexual and reproductive rights of women in this country’€, he says.