The Female Condom

The female condom has not caught on, despite the public health importance of such a device. The need for a female condom is important because of the different transmission rates for sexually transmitted diseases. The male-to-female transmission rate is higher than the female-to-male transmission rate because vaginal receptive intercourse is riskier than vaginal insertive intercourse. To complicate matters even more, the sensual costs vary. For men, wearing a condom lowers the sensual pleasure of vaginal insertive intercourse, whereas a male condom has virtually no effect on the sensual pleasure of a woman. That said, the "benefits" of safesex skew towards females, but the "costs" of safesex skew towards males. If men aren't all that concerned about the safety of their partners, that will suggest that in the population, men will wear condoms less often, thus putting women at risk.

And you can imagine that this problem intensifies in areas where female civil rights are not protected. I'm thinking mainly of married women in developing countries. If a woman suspects her husband is unfaithful, she is unable to negotiate a condom to be worn during either her sex with him, or when he is having sex with his mistress(es). On the latter, she has no way to monitor his activities, and in fact even bringing up the matter of him having safesex with his mistress is probably an impossible conversation to have, even though she would prefer him to wear a condom with every sexual encounter he has with other women in extramarital sexual relationships. Condom use falls dramatically for married people, but if a wife suspects her husband is unfaithful, requesting a condom be worn during marital intercourse is basically a not-so-subtle way of accusing the husband of having extra-marital sex. In some parts of the world, such accusations could result in significant domestic violent retaliation, and if female rights are not protected whereby a wife could file for divorce or the husband be held criminally liable for domestic violence, her threat position is weakened to such a point wherein it is optimal for her to roll the dice and have risky, unprotected sex with the husband she suspects of having an extramarital affair.

The female condom would help deal with this problem. It would put the decision squarely on the female, who is really the person paying the price for unsafe sex. A female condom removes the problem of achieving cooperation with the husband - and you can imagine that cooperation is going to break down more often with the least altruistic husbands, who are probably by definition the men having extra-marital affairs. But a female condom would not address the signalling problem mentioned earlier. A female condom, if discovered by the husband, would indicate the woman believes her husband is unfaithful, and then would trigger the violent response. Apparently, the failure of the female condom to catch on in the world is due mainly to this design flaw - female condoms are not secretive. That is, when a woman is wearing one, her partners knows. It has apparently only caught on among prostitutes.

Therefore it is encouraging to see scientists working on a second generation female condom that solves this problem. The new one will hopefully be secretive, thus enabling married and cohabiting women to protect themselves both from STD risk and the violent repercussions of their husbands. In fact, they have one such prototype, but it is currently held up at the FDA. You can read about it here.