This article, written by Lillian Roberts, is part of an African Alliance series celebrating 25 years of the inner condom in South Africa and the people who helped to establish the world’s biggest state-funded inner condom project.   

Phumlani Kango answers the phone while he’s walking to buy amagwinya with a side of polony and cheese for the children he teaches at Little Angels in Alice in the Eastern Cape. 

The school opened in 1994. In 1996, Kango started there himself as one of the Little Angels’ first preschool students. Now, he teaches social sciences and EMS (economics) to grade 4 to grade 7.  With children up to grade 3, he teaches English, and helps out with art and crafts like paper-mâché.

“Teaching is a calling,” he says. A family friend saw him teach and told him that she could see he possesses this gift. Anyone who has taught could tell you – it’s not for the fainthearted.

That’s not all he does.

Kango is a proudly gay man, a PrEP activist, a writer – mainly writing about men who have sex with men, HIV and mental health – and he’s worked with health advocacy non-profits, and is also a traditional healer.

The safe-sex journey

In 2017, a sexual partner “stealthed” Kango. Stealthing is when someone removes the condom without your knowledge during sex. It is sexual assault, because by definition, it is non-consensual.

If someone suspects they’ve been the victim of stealthing, it’s crucial to go to the closest clinic or hospital within 72 hours and request PEP (post-exposure prophylaxis), a 28-day course of antiretroviral medication which can prevent HIV infection.

Kango immediately went to the hospital after being stealthed, to go onto the emergency PEP course. 

A nurse mentioned the option of going on PrEP (pre-exposure prophylaxis) in general. If it’s taken as prescribed, PrEP is highly effective for preventing HIV infection. Kango then began using PrEP.

“I was shocked, it was something that was introduced to the county in 2016 and people weren’t aware of the rollout, especially people in the gay community. So I figured why not use my platform?”

Kango had garnered a sizable online following, and he’s used his personal experiences to get people talking about stealthing. It led to other online conversations about consent too.   

His online advocacy unearthed some pervasive myths, including the fact that many men believe that they’re entitled to sex if they’re in a committed relationship, whether their partner agrees or not. 

The inner condom ‘goes both ways’ 

It was a clinic nurse who first told Kango about inner condoms. She explained that they could also be used during anal sex. 

The female condom was approved for vaginal use by the Food and Drug Administration in 1993, but not for anal use.

In a study conducted in New York, USA in 2011, five men reported having experienced problems (slipping, leaking, or breaking) with the female condom during anal intercourse but a staggering 70.8% reported problems with the male condom. 

While the sample is small, results may show that men using the inner condom may have less problems with slipping or breaking, and a more pleasurable experience to the male condom.

In 2018, the USA FDA approved new rules for “female” condoms that not only changed the device’s name but eased other regulations about use. The FDA changed the name to “single-use internal condom” in order to change the perception that it is only meant for use by women. The regulators now approve the device for both vaginal and anal sex.

Another great aspect of the inner condom is that while a male condom relies on a fully erect penis to be used, an inner condom stays safe through-out sex for the one receiving sex, or the bottom.

My body, my choice

While working with NGOs about pleasure, safe sex and agency, it reminded Kango how some people don’t have the ability to negotiate condom use in relationships.

The inner condom is important because it affords women agency over their bodies, he explains. In a society where some women aren’t able to negotiate condom use with their partners, the inner condom gives them control over their sexual health, Kango adds.

“When it comes to the inner condom, I noticed there was a gap in the PrEP space, and I wasn’t going to fill the gap because it wasn’t my story to tell. I noticed there weren’t a lot of women speaking about their experiences of using PrEP.”

While working to find women who had been on PrEP, Kango began to learn more about the inner condom and how to use it. But one thing he found in these conversations was the issue of accessibility.

He observed that inner condoms were not found in public bathrooms the same way that external condoms were. If inner condoms were present, they were usually less in quantity than the external condoms. Then, he noticed that cities had more of them, while rural and peri-urban spaces in the country had less.

Fear keeps people from safer sex and health seeking behaviours

“People also know what PrEP is in the rural and urban cities, but no one wants to get tested and I think that’s the most crucial thing that I find,” he explains.

On a campaign in Durban centred around trying to get men on PrEP, people he spoke to did not want to get tested for HIV because they didn’t use condoms.

Fear and stigma is still a factor in South Africa, despite all the gains made in the medical sector to improve the lives of people living with HIV.

“It also just got me thinking on the accessibility of the inner condom for women, because imagine now you have a partner who’s scared to get tested for HIV? A lot of men in relationships get tested through their partners,” Kango explains. “You wait for your wife to get tested, and if it comes back negative, you automatically assume you are negative as well.”

Kango mentions stigma can come from even taking an inner condom from a clinic – where people may assume you aren’t being faithful to your partner.

“My hopes are that it [inner condom] becomes easily accessible for everyone, especially in rural and peri-urban areas. To see more campaigns and roll-outs similar to male condoms.”