NEW ENTRY: The contraceptive could hit the market by 2003

THE USER'S PRIMER

» The female condom has an outer ring that stays outside the vagina and an inner ring to anchor the condom in place inside the cervix. » Insertion requires twisting the inner ring and a gentle push into vagina. It can be inserted up to eight hours before sex and does not depend on male erection. » Once in, it acclimatises to body warmth and clings to the cervix. There could be insertion problems initially, but the manufacturers insist users try it 'at least three times' before giving up.

It will be like handing over the TV remote to womanhood. The control button-in this case, the freedom to go for the medium that will aid contraception and prevent sexually transmitted diseases, including HIV/AIDS-will now change hands. After 50 years and 1,400 million pieces of the male condom sold annually, India is on its way, for the first time, to getting its own female condom (FC).

It may be an unsexy blob, but one that's slated to fulfil the dual purpose of birth control and std/aids prevention. Conventional methods like tubectomy, intra-uterine devices and pills only help prevent unwanted pregnancies. As Kolkata-based gynaecologist Alokendu Chatterjee says, "The FC is the first real reversible barrier method for a woman's protection during sex."

In the last three months, Hindustan Latex Limited (HLL), a government-owned contraceptive maker, has been poring over feasibility reports and marketing strategies to introduce the FC in India. A three-phase trial is on in conjunction with Chicago-based Female Health Company (FHC), the only company in the world to manufacture and market FCs. Besides support from the National aids Control Organisation (NACO) and the Ministry of Health and Family Welfare, the project also enjoys the approval of the WHO and UNAIDS.

Available abroad for 10 years now, the FC could hit medical stores by early 2003 in India. HLL's first round of studies in Andhra Pradesh last month has thrown up "favourable findings". After the necessary approvals, HLL will part-manufacture the product. FHC estimates the market in India will reach nearly 40 million units by four years.

What distinguishes the FC from its male counterpart-made of latex-is its polyurethane sheath, almost like a second skin, thinner and strong enough not to rip or tear. It also absorbs heat from the vagina to make the sexual encounter "more natural".

NACO estimates about four million people living with HIV in India, second to South Africa (4.2 million). Thus the imminent need to promote safe sex. "The FC can lead to a decrease in new HIV infections, while enhancing the social status of women in India," says Mitchell Warren, vice-president and director (international affairs), FHC.

That's also where the new product's social ramifications lie. HLL found in its pilot study that the targets most likely to benefit were commercial sex workers. "It's important for them," says G. Manoj, HLL's area sales manager, "since the men are most often too inebriated to use a condom or they don't want to use one at all." The study, conducted with NGOs in districts of Andhra Pradesh areas where sex workers are active, involved 55 case studies and how-to-use sessions with vagina models. "Some even started charging more from their clients," says Manoj. A few though were put off by the "intimidating" baggy look of the condom.

For now, there are other challenges. At a "global public-sector price" of Rs 30, nearly 10 times that of a costly male condom, the price has to be lowered to be cost-effective, reason why HLL want to part-manufacture it in India.

HLL has entrusted Lowe India in Chennai to brand the product and launch an ad campaign by the year-end. Even the names have been decided: Rani for the rural market and Confidem for the urban. But marketing it is not going to be easy. Agrees Delhi-based gynaecologist Shelly Batra: "The biggest challenge will be the stigma associated with insertion. But if education precedes use, the condom could be a boon." Product consummation may take a while. But for the sex workers in Andhra Pradesh, the FC is already a means to sex without worries.