Facilitators and barriers to use of the female condom: Qualitative interviews with women of diverse ethnicity

Women in the United States, particularly African-Americans and Hispanics, a re at increased risk for HIV. The female condom now offers women a potentia lly important option for HIV prevention, yet few efforts have been made to increase its use. To elucidate strategies to promote the use of the female condom, we conducted in-depth interviews with 62 women recruited from the f our major racial/ethnic groups of the U.S. (African-American, Asian-America n, Hispanic, and white). Subject recruitment took place at a family plannin g clinic in San Francisco during 1996-97. We identified four major types of facilitators and barriers to use of the female condom: mechanical, psychos exual, interpersonal, and situational. Specifically, the mechanical facilit ators and barriers included positive and negative aspects of the device, an d difficulty with insertion. The psychosexual factors were female empowerme nt, more options for contraception and disease prevention, discomfort with vaginal insertion, and condom use norms. The interpersonal factors included : enhanced communication, relationship status, partner preferences, and par tner objections. Finally, the situations that made women disinclined to use the device were: no access to the female condom when having sex and using other forms of contraceptives. The implications of these findings for HIV p revention and future research are discussed.