ALLISON KEYES, host:

I'm Allison Keyes, and this is TELL ME MORE from NPR News. Michel Martin is away.

Coming up, I'll tell you why I think it's not okay that strangers feel they can touch my hair.

But first, it's time to go behind closed doors. It's our weekly conversation, where we take on issues that people don't want to talk about, often because of stigma or shame. This week, we're discussing female condoms. They've been around for almost two decades, but many women haven't heard of them, much less used one. Now there's a push to reintroduce the female condom to the public and make them a must-have accessory in the battle against HIV AIDS.

Nationally, the disease is a leading cause of death for young black and Latino women. Joining us now to talk about this are doctors Shannon Hader, head of the D.C. HIV/AIDS Administration, Nancy Mahon, executive director of the MAC AIDS fund that's providing the funding for the program, and Cecilia Boyd, development coordinator at the Pediatric AIDS Chicago Prevention Initiative. Cecilia also uses the female condom.

Welcome, ladies, and thanks for joining us.

Dr. SHANNON HADER (Director, HIV/AIDS Administration): Thank you.

Ms. NANCY MAHON (Executive Director, MAC AIDS Fund): Thank you.

Ms. CECILIA BOYD (Development Coordinator, Pediatric AIDS Chicago Prevention Initiative): Thanks for having us.

KEYES: I want to warn our listeners, by the way, this conversation is going to be sexually explicit. So it might be a little bit much for young ears.

Dr. Hader, I'm going to start with you. For our listeners who aren't familiar with this condom, tell us: What is a female condom? What's it look like?

Dr. HADER: It is a product that's very similar to male condoms that can prevent pregnancy, HIV/AIDS. And, of course, the difference is it's made for women. So it's got an outer ring and an inner ring, and it inserts into the vagina to be a sort of a coating protection on the inside instead of on the outside.

KEYES: I watched the video for the insertion process, and I've got to say, it looks a little complicated.

Dr. HADER: You know, I think anytime you have a new product, it's sort of scary and awkward and you have to figure it out a little bit. Try it once, try it twice, try it three times. If after three times you decide it's not for you, that's fine. But give it a shot first. Because it looks a little awkward at first, but women learn to use a lot of things, really, pretty well.

(Soundbite of laughter)

KEYES: That is true. Nancy, your group is funding the giveaway of half a million of these female condoms in D.C. Why?

Ms. MAHON: I think what is surprising for people in the U.S. is the rate of HIV infection - particularly for women in D.C. - surpasses that of West Africa and is on par with Uganda and parts of Kenya. And so what we've wanted to do is to work with women to say, if we give you a prevention mechanism that you are in control of, what else do you need in your life, including wraparound services, to help you practice prevention?

Because the bottom line with HIV, as you know, is that it is not curable, but it is 100 percent preventable. And the numbers of women living with HIV in the U.S. have tripled since 1985, and it is the leading cause of death for black women in this country from 18 to 34. And we as a corporation that serve primarily women, feel a huge obligation to address this issue.

KEYES: Nancy, talk to me a little bit about the FC2 condom. This is different than the old ones, which I hear made disturbing squishy noises.

Ms. MAHON: Yes. From the market tests - and we can talk a little bit about this - it's much more appealing to women. I think as Dr. Hader mentioned, I think we have to play around with it. And what is terrific about what we're doing in D.C. is that we have a true private-public partnership.

We're partnering with the CDC, Centers for Disease Control Foundation. CVS is selling the condoms in CVS stores in Washington, D.C., so that once women receive free condoms at the various social services, they can also get them at CVS and buy them. And we're also working with the Department of Health, which very recently released numbers showing that they're seeing great decreases, actually, in HIV infection.

KEYES: All right. I was challenged to open one of these on the air. And, of course, naturally, now my hands are squishy. Oh, there it is. Okay. So, you open the package, and if you are used to male condoms, this is a lot bigger. It's wider around. It's got a ring at the enclosed top, and it's got an open ring at the bottom. And these are lubricated, so they're kind of slimy.

Cecilia, what made you think: I'm going to put one of these on?

Ms. BOYD: You know, it's just being aware, and I think, you know, because we my organization works with HIV-positive pregnant women, I felt that, you know, this is something I need to know how to use if I'm going to be out here telling other women to use it. You know, luckily, I have a very open-minded partner where I was just, like, you know, let's try this thing out. And, you know, this - I had the same impression of it when I first saw it. I was, like, oh, my God. This is huge. How am I going to get this thing in? And like the doctor said, you know, once you try it a few times, you really start to get the hang of it. And I like using it because I feel like I have a greater awareness of my body and I'm taking greater control and responsibility of my pregnancy and STDI prevention.

KEYES: If you dont live in Washington, D.C. and you would like to get a female condom, what kind of distribution network - I mean you can't walk into your beauty shop in say, South Carolina somewhere and get these, can you?

Ms. MAHON: No. The name of the company that sells the female condom is the Female Health Company, and you certainly can get it from their Web site. Also, they are distributed in only at this point in Atlanta and New York, and what we are aiming for as part of this effort is that anywhere a city or locality distributes free male condoms, they will also distribute free female condoms. We're not there yet. So one thing women could do as a call to action is they could ask their local Department of Health for one and ask them why they dont distribute them.

KEYES: Let me ask you. I remember when OB condoms came out a few years ago -I'm sorry not condoms, tampons, the one without the applicators, and a lot of women I knew were pretty much like I'm not doing that without the applicator. So if women are thinking that way, Dr. Hader, how do you convince them that they need to go through this process? Because it is kind of a process to insert it.

Dr. HADER: Well, you know, I think they're similar to OB tampons, they took off. You know, it took a little bit of early adventure, women who are less scared, but it really does come down to giving it a try. And I think what's important about a female condom is what it is is it's a new option, its another option. It's not going to be the only option, but we think that the more options as women you have, the more choices you have, the easier it is to pick and choose whatever option you want to use today.

KEYES: Youre listening to TELL ME MORE from NPR News. I'm Allison Keyes and we're talking about female condoms with Nancy Mahon from the MAC AIDS Fund, Cecilia Boyd from the Pediatric AIDS Chicago Prevention Initiative and Dr. Shannon Hader of the D.C. HIV/AIDS Administration.

Dr. Hader, talk to me a little bit more about the logistics of the program in Washington. Youre going to be going into beauty shops and liquor stores, did I read?

Dr. HADER: Yeah. So, we already have a male condom distribution program that's citywide, and so when we had the opportunity to add on and introduce the female condom, we said, well, we want to start big enough so that it matters, but we want to start concentrated enough that we can really do the grassroots level distribution, education promotion. And so we picked four areas of the city that about 50,000 women live in, and that include beauty salons and clothing stores and shoe stores and things like that. And add in - Mm-hmm?

KEYES: I've got to ask you, if youre walking into a liquor store going, hi, can I have my Wild Irish Rose and, oh, by the way, here's a female condom. I mean, how do you bring that into the conversation there?

Dr. HADER: Well, I think the best examples oftentimes have been barbershops and beauty salons, where people hang out. They start conversations. And even just having that fish bowl of condoms there starts people talking about sex and why are we talking about safer sex and how do you negotiate these things? So we think that these are really friendly places to introduce some of these really important safer sex products.

KEYES: Cecilia, I've got to ask you, you are not only a user of the female condom, but you work for an organization that distributes them.

Ms. BOYD: Right.

KEYES: What kind of response are you running across in Chicago?

Ms. BOYD: I'd say we're running into good and bad responses. We - a lot of our women, particularly our African-American women that we work with, they're just like, I can't do that, I can't wear that. If I pull that out, my man's going to look at me like I'm crazy or whatnot.

(Soundbite of laughter)

KEYES: Did yours?

Ms. BOYD: But - a little bit. He was just like, oh, my god. He's like, you really want to use that? And I'm just like, yeah, let's try this out. Let's try something new, try something different. But we do also serve African women and Southeast Asian women and a lot of them have actually been very open to it because I think they come from places where they dont have that option and they dont have power in their sexual relationship.

KEYES: Mm-hmm.

Ms. BOYD: So when they come here and this organization is giving them an option to protect themselves in their sexual relationships, they're just like, oh, my gosh, this is so awesome and they have actually been very open to the female condom.

KEYES: How many women do you actually know, Cecilia, that are using these? I mean, whether or not theyve tried them, how many are actually carrying these in their purse?

Ms. BOYD: Very few. Very, very few. I mean, even when I, like, I've handed female condoms out to all of my friends and actually they all tell me, like, oh, it's in the back of my purse or its tucked under somewhere. Like, many of them are not giving me their opinions on what has actually happened when they used them or whatnot because they actually haven't - you know, they're just really afraid to, like, I guess bring that discussion out with their sexual partner. And that's - I mean, its unfortunate, but I think as long as we keep talking about it maybe we can get more women using them.

KEYES: Nancy, you talked about - I mean, this is life-threatening. Why are people having such a hard time getting their brains around this?

Ms. MAHON: Well, I think there's enormous denial. But the reality is is many, many people at some point in their relationship have someone on the side. And really, all it takes is one instance of that and youre exposed to a sexually transmitted disease. There's a hesitancy, I think, to talk about sex. I think there's a hesitancy to talk about fidelity with one partner. But the reality is is this is a life-threatening disease and if you look globally, Allison, the number of women being infected with HIV is increasing in every single country globally. And the issue that we have is that women, as the receptive partners, their tissues are much more likely to tear.

KEYES: Mm-hmm.

Ms. MAHON: And so, an HIV-negative woman having sex with an HIV-positive man is much more likely to contract HIV than the reverse. And on top of that, women have the inequities that they face around poverty and violence and inequity within the relationship that just has a multiplier effect on that. So globally, it's not just a problem in Washington, D.C., the bottom line is if this works in D.C. as it has in other countries in Africa, then weve had a huge leap forward globally in prevention for HIV for women.

KEYES: Dr. Hader, by the way, youre saying this is a leading cause of death for young black and Latino women. Is it sexually transmitted HIV/AIDS, or is it something else?

Dr. HADER: Well, I think the vast majority of that is sexually transmitted. The other option is oftentimes injection drug use related. But, you know, we're actually - certainly in D.C., we're in an era where there is a heterosexual HIV/AIDS epidemic. And I think that's something that folks haven't been aware of and a lot of what has also I think prevented women from really being empowered to take care of themselves is we have persistent impressions of 1981, that maybe HIV is still just a gay white man's disease. And that probably wasnt true at the time either, but we know now for sure HIV is a women's disease, too.

KEYES: I'm interested in some of the ways that the people that are giving these out are trying to convince people to use them. I understand that there is some suggestion that they can enhance one's sexual experience, so I've heard.

Dr. HADER: Yeah. This is Dr. Hader. I guess I'm the one to ask...

(Soundbite of laughter)

KEYES: Shes...

(Soundbite of laughter)

Dr. HADER: Come out with the scientific truth. I think it's really interesting, some of the early focus groups of the second generation female condom. And again, what's second generation or new about it is new technology gives you new attributes and it's a new material that's softer. It warms up immediately. But it also, the outer ring is this rolled material. And, of course, that just fits - sits over the outer lips and clitoris. And, who knows, but some people say it becomes an added enhancement to your sexual activity.

KEYES: But the actually point of it covering the external part of the woman's vagina is to guard against disease, right?

Dr. HADER: Well, and to just to leave that entry point for the, you know, the penis goes inside the condom.

KEYES: Dr. Hader, if this doesnt work, if this campaign doesnt work, what are your alternative weapons in this battle against HIV/AIDS?

Dr. HADER: Well, you know, we think of the weapons as a whole tool kit and we dont think that there's ever going to be just one, not for a long time, that is going to satisfy every person's need at every point in their life and every point in time in their day. We did a lot of research and, you know, we found that people sort of had a Rubik's Cube of what made a safe partner. And it was usually, you know, how they're wearing their hair or how much I care about them, or who I know theyve been with before.

And when we boil it down, we boil down the actual data, you know, said, well, you know, if youre going to know three things or make three decisions, what are those? You know, relationships aren't always easy, know where you stand. Do we know each other's HIV status? Is it just the two of us in this relationship? And should we use condoms? Boom.

KEYES: Dr. Shannon Hader is head of the D.C. HIV/AIDS Administration, who joined us here in our D.C. studios. Cecilia Boyd is a development coordinator for the Pediatric AIDS Chicago Preventive Initiative, and she also uses the female condom. She joined us from Chicago. And Nancy Mahon is the executive director of the MAC AIDS Fund that is funding the female condom initiative in Washington, D.C. She joined us from member station WNYC in New York.

Thank you, ladies.

Dr. HADER: Thank you.

Ms. BOYD: Thank you.

Ms. MAHON: Thank you.

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