Access to female condoms improving under Medicaid, but obstacles to use remain
More states are making female condoms available through Medicaid, a new study found. But few women are using them, researchers say.
The female condom is a barrier contraceptive method that protects against both unwanted pregnancy and the transmission of sexually transmitted infections, or STIs. Female condoms have been available since the mid-1990s.
The number of states where Medicaid, the government health insurance program for low-income individuals, provides women with female condoms rose more than 30 percent from 2007 to 2016, researchers report.
When Susan Witte at the Columbia University School of Social Work in New York City and colleagues contacted Medicaid representatives from each state, they found that 36 states currently provide reimbursement for female condoms - 11 states more than in 2007.
Twenty-nine states provided data on claims for female condoms between 2004 and 2014. Some states reported increases in reimbursements while others had decreases.
“Some states had thousands of claims, whereas others had few to none. Some states reimbursed hundreds of thousands of dollars, but others reimbursed less than $10 per year,” the authors wrote in the American Journal of Public Health.
Overall, the numbers of claims appeared to be low, according to the authors.
“Used correctly, the female condom can provide as much protection as the male condom,” Witte noted.
Furthermore, a woman can choose on her own to use it and she can insert it herself, and it is among the few contraceptive options that are also drug and chemical-free, said Witte.
But structural barriers, including poor marketing and a lack of accurate information, may hinder access to and use of the device, Witte said.
For women who must pay for them out of pocket, retail price is likely another barrier. In the U.S., on Amazon.com, female condoms cost about $10 apiece. While at least one study found that female condoms can be carefully washed and reused several times, the World Health Organization recommends using a new one for every act of intercourse where there is a risk of unplanned pregnancy or sexually transmitted infection, including HIV.
Witte believes increasing awareness and building ‘peer norms’ is essential to increasing demand for female condom use.
“In other words, if I use it, and I talk to my friend about it, and then she tells her friend, we start to build awareness to lead to increased use,” she said.
If demand would increase, supplies might increase, said Witte.
In the meantime, if healthcare professionals, including doctors, nurses, medical social workers, community health workers and others know of the device and introduce it, more women might use it, she said.
The U.S. Centers for Disease Control and Prevention has more information about female condoms here: http://bit.ly/2wvtAWD.
SOURCE: American Journal of Public Health, online August 17, 2017.