Several times a year, CBAS distributes an electronic newsletter to subscribers. The newsletter is designed to keep subscribers abreast of new research, activities in the field, and relevant events. Recipients are encouraged to share the newsletter with others. If you have input on the content of the newsletter or have an item of interest to include, contact us at

Note: We are always updating our research listings on the CBAS website. Please contact us at with study updates or information on new research related to cervical barriers or female condoms.

In this July 2012 issue:

Table of Contents:


DC Female Condom Program highly effective in preventing HIV infections and reducing costs new economic analysis conducted by the Johns Hopkins Bloomberg School of Public Health found the DC Female Condom Program, a public-private partnership to provide and promote FC2 Female Condoms® in Washington, DC, was highly effective in preventing HIV infection and resulted in significant cost savings. Researchers estimated that the intervention prevented enough HIV infections in the first year alone to save over $8 million in future medical care costs, and that for every dollar spent on the program, there was a cost savings of nearly $20. 

The DC Female Condom Program is led by the DC Department of Health with support from the Washington AIDS Partnership, CVS/Caremark, and the Female Health Company. Educational services along with more than 200,000 FC2 Female Condoms were distributed in areas in the District with disproportionately high HIV prevalence rates among women. The findings are published in AIDS & Behavior.

Holtgrave DR, Maulsby C, Kharfen M, Jia Y, Wu C, Opoku J, et al. Cost-utility analysis of a female condom promotion program in Washington, DC. AIDS & Behavior. 2012;16(5):1115-20.

Click here to read the full article.


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The UAFC Joint Programme will attempt to break the Guinness World Record of longest chain of paper dolls during the International AIDS Conference in July in Washington, DC. They need your help!

The Universal Access to Female Condom (UAFC) Joint Programme, a nonprofit partnership working for accessibility and availability of female condoms, launched the Paper Doll Campaign in 2011 to illustrate the growing demand for female condoms by creating long chains of paper dolls containing individual messages about female condoms. During the International AIDS Conference in Washington, DC, from July 22-27, UAFC and their partners will display the dolls that have been collected worldwide and ask participants to complete their own doll, which will be attached to the growing chain. The goal is to break the record on Friday the 27th, the last day of the conference, when 30,000 dolls are collected and create a chain nearly six kilometers long.


If you would like to contribute to the chain and are unable to do so in person, you can submit your message online at or via Facebook. These messages will be transferred to paper dolls and form part of the chain that will be displayed at the International AIDS Conference.   


To learn more about the Universal Access to Female Condom Joint Programme, please visit:


(Photo: UAFC paper dolls)

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Save the date! Global Female Condom Day: September 12, 2012
The female condom has the potential to revolutionize safer sex practices for women and men around the world. On September 12, 2012, join HIV/AIDS, reproductive health and justice, women’s health, youth, and gay men’s health organizations and advocates from around the world for the first ever Global Female Condom Day. Though a highly effective safe-sex option for women, men, and youth, most people remain unaware about female condoms or are unable to access them. Global Female Condom Day aims to increase the number of women and men around the world who know about, use, and advocate for female condoms.  Be a Part of Global Female Condom Day!


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Bridging the gap: The development of the National Female Condom Coalition in the US

(By the NFCC)

The 2009 FDA approval of the second generation female condom (FC) gave STI/HIV prevention and reproductive health providers and advocates the rare opportunity to reintroduce this highly effective safer sex tool. To this end, six US cities (Atlanta, Chicago, Houston, New York City, San Francisco, and Washington DC, and later Baton Rouge and New York State) independently developed new or enhanced existing community-based FC projects. While launching in quick succession, these programs operated in isolation. Additionally, the US lacked a unified vision to increase FC awareness and use.

To maximize local impact and generate widespread support for the only receptive partner initiated prevention tool, in January 2011 the AIDS Foundation of Chicago (AFC) worked with CHANGE and support from the MAC AIDS Fund to convene the jurisdictions that had FC campaigns or programs to meet each other, learn from each other, and identify future collaborations. Work continued through monthly planning calls and additional communication, and in October of 2011, these jurisdictions launched the National Female Condom Coalition (NFCC).

The October 2011 meeting brought together colleagues from STI/HIV prevention, reproductive health and justice, and other related fields to discuss current FC work and identify new strategies for moving forward. These organizing efforts resulted in:


  • A formalized collaboration among eight FC jurisdictions and approximately 50 agency partners known as the National Female Condom Coalition;
  • Development of a brain trust dedicated to FC mobilization in the US; and
  • A coordinated national advocacy agenda focused on:
    • Bridging family planning and HIV prevention movements;
    • Gaining FDA approval for FC anal use;
    • Improving branding/marketing of FCs to increase appeal among broader audiences;
    • Promoting research-supported effective FC education; and increasing FC affordability

The engagement of FC programs and diverse stakeholders enabled the development of a coalition solely dedicated to advancing FCs as a viable HIV, STI, and pregnancy prevention tool. The work of the National Female Condom Coalition will continue to result in greater FC awareness, acceptance, access, and use among US women, men, and trans people.


For more information on the NFCC, please contact Jessica Terlikowski or visit their website (coming soon!) at:


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The following are abstracts of research studies on topics related to cervical barrier methods and female condoms.

A randomized controlled trial to evaluate a structural intervention to promote the female condom in New York State

Exner T, Tesoriero J, Battles H, Hoffman S, Mantell J, Correale J, et al. AIDS and Behavior. 2012; 16(5): 1121-32.

Abstract: We conducted a structural intervention to promote the female condom (FC), comparing 44 agencies randomized to a Minimal Intervention (MI) [developing action plans for promotion and free access] or an Enhanced Intervention (EI) [with the addition of counselor training]. Intervention effects were evaluated via surveys with agency directors, counselors, and clients at baseline and 12 months. Agency-level outcomes of the FC did not differ between the two interventions at follow-up. Counselors in the EI showed significantly greater gains in FC knowledge and positive attitudes, although there was no difference in the proportion of clients counseled on the FC, which significantly increased in both conditions. There was a greater increase in intention to use the FC among clients in EI agencies. Intervention effects were stronger in medical agencies. Findings suggest that making subsidized FCs available and assisting agencies to formulate action plans led to increased FC promotion. Limitations and implications for future research and intervention efforts are discussed.

Couples' acceptability of the SILCS diaphragm for microbicide delivery

Frezieres RG, Walsh T, Kilbourne-Brook M, Coffey PS. Contraception. 2012 Jan; 85(1): 99-107.

Background: Disposable plastic applicators used in microbicide gel studies are expensive and have a negative environmental impact. The SILCS diaphragm is a barrier contraceptive that could offer a reusable delivery system.

Study design: Thirty-six couples in this randomized, cross-over study evaluated single- and double-sided gel delivery from a SILCS diaphragm compared with gel from an applicator. Couples used each gel scenario during two acts of intercourse and completed acceptability questionnaires after each.

Results: All three scenarios received favorable ratings for ease of application, acceptability and perceived effectiveness. Both female and male participants tended to rate the gel applicator significantly more favorably than either SILCS gel delivery scenarios for all attributes except messiness/leakage and effectiveness. Additionally, about 60% of female participants and about half of male participants preferred the gel applicator to either of the gel delivery systems using SILCS. The preference for the SILCS scenario for pregnancy protection was statistically significant for both sexes. Male participants were also significantly more likely to prefer the SILCS single-sided delivery system to the gel applicator for protection from sexually transmitted infection.

Conclusions: In this study population, participants found the gel applicator to be more acceptable than either single- or double-sided gel delivery from a SILCS diaphragm. Further research of the SILCS as a microbicide delivery system should be implemented to assess its acceptability among study populations that reflect diverse potential user groups such as women and men from both low and high HIV prevalence settings including HIV-positive populations and with and without experience using female barrier methods.

Click here to read the full article.

Condom type may influence sexual behavior and ejaculation and complicate the assessment of condom functionality

Haddad L, Gallo MF, Jamieson DJ, Macaluso M. Contraception. 2012 Mar 23. [Epub ahead of print]

Background: Studies that evaluate condom effectiveness are affected by factors related to how the condom was used, and these factors may not be consistent between different types of condoms. Also, subjective assessments of the sexual act may be unreliable.

Study design: We performed a secondary data analysis of a randomized crossover trial of male and female condoms among 108 couples.

Results: Self-reported duration and activeness of coital acts were significantly different for uses of the male condom compared to uses of the female condom. Fewer individuals reported ejaculation occurring with the female condom. Reliability of self-reports of ejaculation compared to a biological marker of semen detected inside the used male and female condoms was not strong.

Conclusions: We found that sexual behaviors appear to differ by the type of condom used for the coital act. Studies should consider sexual behavior when evaluating condom effectiveness. Furthermore, studies would be strengthened by the use of a biological marker of semen to determine whether ejaculation, and therefore a true risk of exposure, occurred.

Results from a national survey on awareness, attitudes, access, and use of female condoms in the United States: Created and disseminated by the National Female Condom Coalition (NFCC)

(By the NFCC)

Background: In the US, men who have sex with men (MSM) continue to be disproportionately affected by STIs/HIV. Among women, heterosexual intercourse accounts for 84% of new HIV diagnoses. Effective STI/HIV prevention strategies are critical. The Female Condom (FC) is the only receptive partner-initiated, physical barrier method available that protects against STIs/HIV, yet awareness, acceptance, and access are limited.

Methods: The National Female Condom Coalition is a partnership of community-based organizations and government agencies dedicated to increasing awareness and availability of FCs. In July 2011, the coalition launched a national FC survey, with the aim of evaluating attitudes and use. The survey was for people of all genders and sexual orientations who had engaged in vaginal or anal sex in the previous 12 months.

Results: Over 2,000 people responded. Preliminary data show that 70% were female, 28% male, 0.5% trans male, 0.5% trans female; the majority were heterosexual/straight (61%), 19% homosexual/gay/lesbian, and 11% bisexual. Approximately 55% were between the age of 20-34 and 67.5% were white, 22% black/African American, and 12% Hispanic. When asked whether they had heard of the FC, 89% said yes and 72% had seen them available. These results differed significantly (P<.05) between cities with FC programs vs. those without. Experience with FCs rated lower compared to traditional/male condoms for vaginal sex but higher for anal sex. Almost 80% said there are barriers to use. The main barrier preventing more people from using the FC for vaginal sex was being “unaware that the FC exists” (81%) while for anal sex, 72% said it was “not knowing that the FC can be used for anal sex.”

Conclusions: Lack of awareness, education, and access has limited people’s use of the FC. This survey provides the first nationwide snapshot of FC attitudes and barriers to use for vaginal and anal sex. These findings will inform the coalition’s efforts to improve attitudes, awareness, access, and use.

Prostate-specific antigen as a biomarker of condom failure: comparison of three laboratory assays and self-reported condom use problems in a randomized trial of female condom performance

Walsh T, Warner L, Macaluso M, Frezieres R, Snead M, Wraxall B. Contraception. 2012 Jul;86(1): 55-61.

Background: Prostate-specific antigen (PSA), a biomarker for semen exposure, may provide a more objective measure of condom failure than subject self-reports. Methods for measuring PSA vary and their comparability with respect to assessing condom performance has not been adequately evaluated. This study compared results from three different PSA assays of vaginal samples collected by subjects in a randomized clinical trial which compared the performance of female condoms.

Study design: We selected 30 pairs of pre- and post-coital vaginal samples from subjects who reported condom functionality problems or whose original PSA assay was positive. Samples were retested using three different PSA assays [quantitative enzyme-linked immunoassay (EIA), rocket immune-electrophoresis (RIE), and chromatographic immunoassay (CIA)]. We compared the proportion of condom uses where the post-coital PSA result indicated semen exposure for each of the three assays.

Results: Despite varying levels of sensitivity, the results from all three assays were remarkably consistent. Self-reported condom failures did not correlate well with positive PSA results, suggesting that exclusive reliance on either PSA or user self-report may be inadequate for assessing condom functionality.

Conclusion: In combination with user self-report of condom failure, PSA testing provides a reliable, objective marker of condom functionality. Studies based on PSA testing may improve on conventional contraceptive clinical trials by offering a more direct assessment of a condom product's ability to prevent semen exposure.

Performance of the Woman's Condom among couples in Shanghai, China

Zirong H, Junqing W, Coffey PS, Kilbourne-Brook M, Yufeng Z, Wang C, et al. The European Journal of Contraception and Reproductive Health Care. 2012; 17(3): 212-8.

Background: The Woman's Condom, a second-generation female condom, is poised for introduction in China.

Study design: This single-arm couples' use study was conducted in China in 2010 to assess performance and safety of the Woman's Condom and feasibility of mobile phone technology to record adherence data.

Results: Sixty couples were enrolled in this study, and 59 couples completed all four of the condom uses, resulting in 234 condom uses. Two condoms were opened but not used. Total breakage was 0.85% (two non-clinical breakages). Misdirection (2%), invagination (0.85%) and slippage (1%) were consistent with data on condom failure from other studies. Total clinical failure was 4%. Fifteen mild and no serious adverse events were reported during the study.

Conclusions: This study has shown that in China, the Woman's Condom performs well. Mobile phones cannot yet replace the use of a coital log and questionnaire. Further work on effectiveness is required.

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Contraceptive Technology Conferences

The Contraceptive Technology 2012 conference was held in San Francisco, CA, USA March 7-10, 2012 and Boston, MA, USA March 28-31, 2012. Chaired by Dr. Robert Hatcher, the conference faculty included the authors of Contraceptive Technology and other nationally known reproductive health experts. The conference brought together health specialists to focus on an array of topics, including new and future methods of contraception, sexuality issues, adolescent health, STI treatment, and flexible OC management. To learn more about the Contraceptive Technology conference, please click here

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2012 International Microbicide Conference – From Discovery to Delivery

The 2012 International Microbicide Conference was held in Sydney, Australia, April 15-18, 2012. The conference brought together hundreds of top scientists in the HIV prevention field and advocates from around the globe for three days of discussion focused on access to prevention technologies, adherence in clinical trials, innovative financing, dual prevention technologies, and new methods of preventing rectal transmission of HIV. Please see below a list of posters and presentations that highlighted diaphragms and female condoms and visit the conference website for more information.

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12th Congress of the European Society of Contraception and Reproductive Health - Myths and misconceptions versus evidence on contraception

The 12th Congress of the European Society of Contraception and Reproductive Health was held in Athens, Greece, June 20-23, 2012. The title of the congress “Myths and misconceptions versus evidence on contraception” reflects that despite dissemination of information, the availability of contraceptives, and the achievements in the fields of reproductive health, there are still misconceptions. The 12th Congress presentations were based on the results of evidence-based research, in contribution to the goal of revealing the truth about contraception and dispelling the common myths and misconceptions. Please see below a list of posters and presentations that highlighted diaphragms and female condoms and visit the conference website for more information.

  • Female barrier methods (Presentation; C. Mauck)
  • Free communication: New female barrier methods designed for acceptability (Presentation; Maggie Kilbourne-Brook)

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International AIDS Conference 2012

Date: July 22-27, 2012

Location: Washington, DC, USA


Description: The International AIDS Conference is the premier gathering for those working in the field of HIV, as well as policy makers, persons living with HIV, and other individuals committed to ending the pandemic. It is a chance to assess where we are, evaluate recent scientific developments and lessons learnt, and collectively chart a course forward. The AIDS 2012 program will present new scientific knowledge and offer many opportunities for structured dialogue on the major issues facing the global response to HIV. A variety of session types – from abstract-driven presentations to symposia, bridging and plenary sessions – will meet the needs of various participants. Other related activities, including the Global Village, satellite meetings, exhibitions, and affiliated independent events, will contribute to an exceptional opportunity for professional development and networking.

Click here to see a list of female condom-related activities at AIDS 2012.


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Event: Integration for Impact Conference

Date: September 12-14, 2012

Location: Nairobi, Kenya


Description:  There is growing interest within the global health community in the potential public health impact of integrating different health services into a single delivery setting. Integrating programs for HIV, family planning (FP), and maternal, neonatal, and child health (MNCH) would address patients’ multiple needs at once, and may enhance program effectiveness and efficiency. Integration for Impact, an international conference devoted to this topic, aims to bring together key stakeholders from sub-Saharan countries with a high burden of HIV, unmet need for FP, and high child and maternal morbidity/mortality to present the latest research findings on the impact of integrating HIV and reproductive health services, identify research priorities for expanding the evidence base on integration, and lay out strategies for strengthening integration policies and translating research into practice.


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Event: The 5th Africa Conference on Sexual Health and Rights

Date: September 19-22, 2012

Location: Windhoek, Namibia


Description: The 5th Africa Conference on Sexual Health and Rights will take stock of responses to sexual health and rights on the continent since the International Conference on Population and Development, and interrogate the status of sexual health and rights, with particular focus on women, girls, adolescents, and youth. The conference is being hosted by the Namibia Planned Parenthood Association (NAPPA), an affiliate member of the International Planned Parenthood Federation (IPPF) under the auspices of the African Federation for Sexual Health and Rights.

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Event: Reproductive Health 2012

Date: September 20-22, 2012

Location: New Orleans, LA, USA


Description:  Reproductive Health 2012 is the premier conference in reproductive and sexual health sponsored annually by ARHP. This clinical conference combines the latest research science with interactive, hands-on training and offers take-home points for immediate practice improvement.

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Event: FIGO Rome 2012

Date: October 7-12, 2012

Location: Rome, Italy


Description: The FIGO Congress in Rome promises to be informative, innovative, and interesting. There will be new and exciting presentations in each subspecialty area (Gynaecological Oncology, Maternal and Fetal Medicine, Reproductive Medicine, Sexual and Reproductive Health, and Urogynaecology). Problems relevant to work in low-resource settings will be discussed in each of these areas and will also be separately featured. Topics specific to FIGO will include the roles of professional societies in providing leadership and in capacity building, new classifications for tumor staging and for uterine bleeding, and international educational initiatives.


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Event: North American Forum on Family Planning

Date: October 27-29, 2012

Location: Denver, Colorado, USA


Description: Society of Family Planning’s (SFP) annual meeting is part of the new North American Forum on Family Planning, launched in 2011 and sponsored jointly by SFP and Planned Parenthood Federation of America (PPFA). This two-day meeting, along with the SFP pre-conference Career Development Seminar, is held each autumn in a different city. Session topics include new research and clinical practice issues related to contraception, abortion, STIs, sexuality, and how to translate the best evidence into clinical practice. Additionally, SFP will be the lead partner in managing the scientific abstracts



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CBAS Steering Committee


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To comment on anything you read in the CBAS newsletter or to contribute a story, event, or news item, please email CBAS.


Ibis Reproductive Health

CBAS is coordinated by Ibis Reproductive Health