title: Building young women's knowledge and skills in female condom use: lessons learned from a South African intervention.
abstract: Partner negotiation and insertion difficulties are key barriers to female condom (FC) use in sub-Saharan Africa. Few FC interventions have provided comprehensive training in both negotiation and insertion skills, or focused on university students. In this study we explored whether training in FC insertion and partner negotiation influenced young women's FC use. 296 female students at a South African university were randomized to a one-session didactic information-only minimal intervention (n= 149) or a two-session cognitive-behavioral enhanced intervention (n= 147), which received additional information specific to partner negotiation and FC insertion. Both groups received FCs. We report the 'experiences of' 39 randomly selected female students who participated in post-intervention qualitative interviews. Two-thirds of women reported FC use. Most women (n= 30/39) applied information learned during the interventions to negotiate with partners. Women reported that FC insertion practice increased their confidence. Twelve women failed to convince male partners to use the FC, often due to its physical attributes or partners' lack of knowledge about insertion. FC educational and skills training can help facilitate use, improve attitudes toward the device and help women to successfully negotiate safer sex with partners. Innovative strategies and tailored interventions are needed to increase widespread FC adoption.
authors.affiliation: Mailman School of Public Health, Columbia University, New York, NY 10032, USA, School of Social Work, University of Southern California, Los Angeles, CA 90089, USA, acschuyler@gmail.com.
authors.forename: A C
authors.initials: AC
authors.lastname: Schuyler
authors.affiliation: Independent HIV Researcher, New York, NY 10032, USA.
authors.forename: T B
authors.initials: TB
authors.lastname: Masvawure
authors.affiliation: MatCH Research [Maternal, Adolescent and Child Health Research], Department of Obstetrics and Gynaecology, Faculty of Health Sciences, University of the Witwatersrand, Durban, South Africa, School of Pharmacy and Pharmacology, Faculty of Health Sciences, University of KwaZulu-Natal, Durban, South Africa and.
authors.forename: J A
authors.initials: JA
authors.lastname: Smit
authors.affiliation: MatCH Research [Maternal, Adolescent and Child Health Research], Department of Obstetrics and Gynaecology, Faculty of Health Sciences, University of the Witwatersrand, Durban, South Africa.
authors.forename: M
authors.initials: M
authors.lastname: Beksinska
authors.affiliation: MatCH Research [Maternal, Adolescent and Child Health Research], Department of Obstetrics and Gynaecology, Faculty of Health Sciences, University of the Witwatersrand, Durban, South Africa.
authors.forename: Z
authors.initials: Z
authors.lastname: Mabude
authors.affiliation: MatCH Research [Maternal, Adolescent and Child Health Research], Department of Obstetrics and Gynaecology, Faculty of Health Sciences, University of the Witwatersrand, Durban, South Africa.
authors.forename: C
authors.initials: C
authors.lastname: Ngoloyi
authors.affiliation: HIV Center for Clinical and Behavioral Studies, Division of Gender, Sexuality and Health, New York State Psychiatric Institute and Columbia University, New York, NY 10032, USA.
authors.forename: J E
authors.initials: JE
authors.lastname: Mantell
mesh_terms: D019111:Single-Use Internal Condom / Q000706:statistics & numerical data*; D005260:Female; D006266:Health Education / Q000458:organization & administration*; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D017008:Negotiating; D011247:Pregnancy; D049168:Pregnancy, Unplanned; D021841:Safe Sex; D012747:Sexual Partners / Q000523:psychology*; D012749:Sexually Transmitted Diseases / Q000517:prevention & control; D013019:South Africa; D014495:Universities; D055815:Young Adult