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. More over, because of the changing focus of the epidemic, the ratio of male to f emale cases dropped from 28 : I in 1984 to 2.7: 1 in 1997. While women's ri sk of infection continues to grow, there is evidence to suggest that tradit ional 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 protec tion from HIV. As part of a larger HIV/AIDS intervention study targeting lo w-income, cocaine users, the primary aim of this initiative was to assess t he level of acceptability of this new device among women at high-risk for H IV infection in Rio de Janeiro, Brazil. In conjunction with individual pre- test HIV prevention counseling, clients participated in a detailed educatio n/demonstration session with the female condom. Women were asked to try the female condom with their partners and to report their experiences at two p oints of contact. Outcome data indicate that a sizable proportion (71.1%) o f the sexually active women used the female condom during vaginal sex on on e or more occasions. In addition, many women continued to use the female co ndom as a method of risk reduction over the three-month follow-up period. T hese data suggest that the female condom can have an important role in HIV prevention efforts in Brazil.