Pina colada and berry flavoured vaginal lubricant.

Green apple-scented condoms.

These are just but a few of the enticements featured at the Condom Project stall at this year’s  18th International AIDS Conference, which opened on Sunday. The organisation, which is part of the larger Condomise Campaign, boasts a stall with an array of colourful condoms, genital lubricants and other aids which the general public are free to sample and taste.

But amid the kaleidoscope colours of sensuality and allure, the female condom still looks unappealing in its white, pink and blue packaging.

As Joy Lynn Alegarres, the Director of Global Operations for the Condom Project, explains, the FC2 female condom, the only condom currently approved for  global use, is undergoing a rebranding (through partners such as UNFPA)and will soon reflect the identity of the various countries where women use it.

“In Bali, the packaging is now pink with a flower on it,” explains Alegarres.

As Maya Gokul of South Africa observes, the female condom is available in over 120 countries of the world and has passed tests of approval from the US Food and Drug Administration (FDA) and the World Health Organization (WHO).

And it can be sexy.

“Since the inner ring is detachable, it is exciting for guys,” adds Gokul. “When the penis bumps against that inner ring it is very sensual.”

She also added that a male partner can use the inner ring to arouse the woman through playing with her clitoris prior to putting the condom on.

And as Nienke Blauw of the Netherlands demonstrated, there are newer models of the female condom that may soon be on the market that can add to the variety for the female condom.  One condom, which is called the cupid and is being developed in India, has a sponge instead of an inner ring which is meant to gave a different sensual experience to the user. Another is cone-shaped and has a tampon-like tip which expands to fit into the inner vaginal lining upon contact with moisture. Unlike other female condoms, it does not use lubricant as it makes use of the woman’s fluids to eventually open up after insertion.

But while innovation around the female condom is increasing, barriers still exist.

“In Zambia, female condoms are going for a (United States) dollar for a pack of two,” explained Carol Nyirenda of the Coalition of Zambian Women Living with HIV.

Prices of female condoms remain much higher than those of male condoms, which means that many women cannot afford to buy the only HIV prevention device that they can control themselves.

Currently, Zambia’s activists are in the process of lobbying the Ministry of Trade and Industry to review and formulate policy for the regulation of the quality of privately imported male and female condoms by 2011.

Also, Nyirenda stressed the importance of educating those who use the condom to do so correctly and consistently, and also to challenge cultural norms that increase women’s vulnerability to HIV transmission, such as marital rape.

“There is need to work on cultural norms which promote the subordination of women, especially in terms of sex, notes Tabona Shoko,the Director of Zimbabwe’s National Network of People Living with HIV and AIDS (ZNNP+), who is an advocate for the female condom. “We need to create leeway for women to negotiate for safer sex.”

Interestingly, Annie Michelle Salla of Cameroon shared that in her country, male military officials had actually requested that rather than train them to use the male condom effectively, they requested that condom promoters train their wives to use the female condom.

The reason?

The men felt that it was important for their spouses to be able to protect themselves since they admitted that they were not responsible enough to do so.

Roli Mahajan, a journalist from India also feels strongly that the female condom should become more widely available and affordable. But when asked how it could be improved, she admitted to never having used it.

Veanne Turczynski from Germany has also never used the female condom but is sceptical about the product. “I cannot imagine that it’s practical to use because it’s hard to handle,” she noted. “It’s so much more complicated than the male condom.”

But with an HIV epidemic that still affects far more woman than men, the female condom remains a tool well worth investing in – for the sake of women’s health.

Tariro is a secretary who wants to do her job well. But Mr Kunaka has other ideas about what her duties should be.

Listen to this seralised audio drama about sexual harassment in the work place.

In the second issue of the Kubatana vendor wrap, Zanele Manhenga wrote about people who make Zimbabwe work. She cited a kombi driver as an example and explained how these people are important to our day-to-day activities.

When distributing the second vendor wrap in Greendale, we met Mai Fungai who operates a tomato and vegetable market. Her crew includes Mai Sharon, Mai Peter and Mai Matwins. With their tomatoes neatly packed and ordered in an appetizing manner, Mai Fungai was not hesitant to have a photograph taken. Posing in several stances, she proudly shouted “Ndini iyeyo nemusika wangu” meaning ‘it is me with my table’. With her colleagues shouting in support the whole place turned lively as we laughed together.

In these people it is easy to notice the time and effort that they employ in neatly packaging their tomatoes and vegetables. What cannot be hidden from their character and faces is the pride that they have about their work. It is clear that these women do not have much in terms of material wealth, but they have all that it takes to be happy and enjoy their work. It is true that positive thinking and enough effort yields positive results and satisfaction.

Surely if we could all be this happy and proud of our work, Zimbabwe would bloom with the flowers of joy.

As a gender and HIV activist, getting the opportunity to attend the 26th UNAIDS Programme Coordinating Board (PCB) meeting in Geneva, Switzerland, as a female youth observer was very important for me.

Coming from Zimbabwe where HIV infection leans more towards women than men, I am always aware of the need for women and girl’s empowerment against oppressive gender norms if my nation is to ever overcome the epidemic which still stands towering above us at over 14% prevalence.

Prior to the two-day PCB meeting, and as part of the programme, I attended a thematic session on integrating sexual and reproductive health (SRH) and HIV services.

Quite honestly, I had never really thought of the intricacies of linking Sexual Reproductive Health (SRH) and HIV services, although I had always known about the importance of providing HIV testing and treatment services within antenatal care for pregnant women and girls.

At the thematic session, however, I learnt just how far back we are falling on this.

As Gottfried Hirnschall of the World Health Organization (WHO) shared, HIV is currently contributing to 19.2% of global maternal deaths in the 15-44 year age group. And TB is contributing a further 6.4%.

Imagine that.

TB and HIV – both manageable diseases, when early detection and treatment are available – are accounting for a quarter of the deaths of all pregnant women in the world.

And with southern Africa, my region of the world, being the area most affected by HIV, that means that even more women here are dying needlessly. National HIV statistics from all over the region consistently show that HIV prevalence among pregnant women who attend antenatal clinics is usually much higher than overall national figures.

It was therefore heartening to hear about some of the good work being done in the region to begin to address the urgent need for stronger integration of services.

Dudu Simelane of the Family Life Association of Swaziland gave a perspective from her country of the successes and opportunities for integration.

Her organisation is working with various development partners to provide youth-friendly SRH and HIV services that integrate interventions such as screening for STIs and TB, HIV tests, pap smears for cervical cancer, pre-and post abortion care, male circumcision, ART and the promotion of condoms for dual protection (that is, using condoms not only to prevent contracting HIV but also to prevent unwanted pregnancies).

What’s good about such sites is that they provide a broad range of services under one roof.   And ultimately, this cuts down on a woman’s use of usually scarce resources such as money and time. So instead of spending two amounts of bus fare to first get to an HIV testing centre and then to the STI clinic where she’s been referred, a woman only spends one amount to get all the services she needs. This also saves her time for travel, which is also often a very practical barrier to a woman being able to access services.

But perhaps even more importantly, such integration helps to reduce stigma. As a visitor to one of the Swazi sites noted, “It’s not like other clinics where I have to go to the ART wing. I go to the same dispensary as everyone else to get my medicine.”

That sort of set-up does a world of good to fight stigma and discrimination. I have heard ghastly stories in Zimbabwe about how people who visit the opportunistic infections clinics of hospitals are set apart from other people receiving services and labeled imi vanhu veHIV (you people with HIV).  Such treatment has serious influence on whether a person will continue to come to collect their medicine every month and can actually lead them to stop taking drugs completely, thereby building up drug resistances and damaging the immune system.

If you think stigma doesn’t kill, think again.

As Sofia Gruskin of the Harvard School of Public Health reminded us, one of the main obstacles to integration is stigma and discrimination. And sadly, this is usually perpetuated by the very workers in the health sector. Gruskin cited examples of the prejudice of healthcare workers in many parts of the world who refuse to offer contraceptives and STI services to unmarried women (who in the eyes of the workers should not be having sex in the first place). And on the flip side of the coin, there are health workers who will not give a married woman contraceptives in the belief that she should be having as many children as possible.

In its most extreme manifestation, stigma and discrimination has seen healthcare workers sterilisng HIV positive women, after childbirth, to ensure that they do not have the option to have any more children.

Also, what’s been found at the sites in Swaziland is that there has been increased male involvement through the provision of male circumcision (MC) as an entry point. Studies have already shown that MC has high efficacy rates of around 60% when it comes to HIV prevention (if practised with correct and consistent condom use) and providing it in such a setting seems like a good way of ensuring that men don’t shy away from being seen with their partners at sites which they would ordinarily think of as places for women.

Morolake Odetoyinbo of Nigeria’s Positive Action for Treatment Access pointed out how culture and socialisation leads to the detachment of men from SRH issues by always teaching girls about SRH and not doing the same for boys.  In many African cultures, it is acknowledged that a woman’s virginity is the greatest prize that she can ever give a man. And also, it is commonly emphasised that her role within sexual intercourse is solely to please her man. To this effect, women in some Zimbabwean cultures are instructed to pull on their vaginal labia from an early age so that these lips protrude. Apparently, this has an effect on sensation and stimulation for a man during sex.

But nothing is without its challenges. As Simelane pointed out, healthcare providers can become overwhelmed by demand for the integrated services, seeing more patients than usual. Also, there tends to be increased client waiting time due to provision of HIV counselling and testing which is a time-consuming process.

For such service integration to be successful, there is need for a range of competencies, including capacity building as well as the fostering of strong partnerships with national and international organisations that may be able to provide staff on secondment or funds towards integration.

And a word of warning.

Integration doesn’t necessarily mean cost saving. In order to be effective, it requires a lot of investment and patience. It takes time to change perceptions and attitudes. Donors need to be aware of this and should not expect radical results within a short amount of time.

And you can’t put all expectations of success on the donor’s shoulders either.

A comprehensive country response to SRH and HIV integration will require the cooperation of civil society, government and the private sector with overall leadership and coordination by the national AIDS authority. National HIV plans will need to be better linked with national SRH plans. Funding streams will need to stop supporting vertical structures.

So how can all of this work in the real world?

The most important thing is for healthcare workers to stop moralising and stigmatising patients. Rigorous training and monitoring is required. Journalists and the media should be mobilised to write articles on the matter so that the general public can know when they are receiving sub-standard services.  A healthcare worker’s role is to provide quality service – and not an opinion.

Secondly, I believe that current upscale of MC in Africa provides an immense opportunity for SRH and HIV integration.  Rather than set up stand alone MC sites that drain resources in terms of infrastructural development and staff recruitment, let’s look at integrating them into pre-existing sites. Also, when we finally develop an effective HIV-preventing microbicide, this must be accessible in terms of cost, as well as available as part of a holistic range of sexual and reproductive health services. In other words, I should be able to get my microbicides at my local clinic, and not at some high-tech lab.

And let’s make sure that everyone who needs to get HIV services can do so. Antenatal care coverage in Africa is still too low. In fact, some women still don’t know about it. Let’s take the information and the services to the people and build the capacity of community-based initiatives.

But most importantly, let’s remember that sexual and reproductive health rights are human rights. No, they aren’t a passing fad or the latest NGO buzz. When implemented, they represent human lives saved and money well spent.

Scanning The Herald newspaper today, I noticed how women hardly feature and when they do, they’re generally criticised. We live in a such a man’s world. A world where the emphasis is all on men. Women are still treated as inferior beings whether it be in the classroom, office, or on the sports field. In society women are often treated as if they are a piece of meat. A lot of women are harassed and treated disrespectfully by men. They are whistled at and flirted with constantly.

This disrespectful treatment is extremely evident in the case of sport and particularly in the case of sports magazines that feature half naked women in bikinis. Women let themselves down by allowing themselves to be exploited for a male dominated market where sex sells. Let’s see some actual sports women on the cover of Sports Illustrated, instead of wafer thin super models with bleached blonde hair.

In October 2009 Sports Illustrated featured an article in which they suggested “Sports men who score the most  . . . talent for the game leads to spotlight of fame. Fame leads to money. And money leads to . . . honey” – sports stars get the hottest dates. Fact. Those who score on the field usually score off it too . . .who is complaining?”

I am.What message are they trying to put across? Women are simply regarded as an accessory. What is this saying to the youth of today? It portrays women purely as sex symbols and nothing more .

Then when Sports Illustrated finally features an article on an actual sports woman, its high jumper Blanka Vlasic winner of the gold medal at the world championships in Berlin and she is given absolutely no recognition for her true talent and ability but rather credited as “hottie of the year”.

I find this completely demeaning.

Living and studying in South Africa at the moment, I have realised that there is a huge problem with violence and especially violence of a sexual nature such as rape. Thousands of women are raped each year in South Africa and it is quite clear that something needs to be done.

About two months ago, my friend and I were running in Grahamstown South Africa. We run the same route every day; it is an 8km route around Grahamstown and is the prescribed running route for all the schools in Grahamstown. As it was Saturday my friend Jenna and I decided to run later and have a bit of a lie in. We started our run at 7am and were coming to the end of our run when we were attacked by a man with a knife. The man got on top of me with the knife and proceeded to rummage through my pockets for valuables.  It was clear that neither me nor my friend had any valuable possessions on us. But still this man continued to hold me down with the knife and that is when I seriously believed I was going to be raped or murdered. Eventually we were able to get  free and run away. This incident occurred less than a ten metres from a main road and less than a hundred metres from St Andrews school in an upper class residential area in broad daylight. When are you safe? Never.

I believe that the concept of the “female condom with teeth” does not solve the problem of rape. When do I wear this condom? I could be raped anywhere at any time. Every time I go out I would need to wear this condom, because to be quite frank there is a high chance of being raped in South Africa regardless of the time or place. The idea is good but it creates more problems for the victim because not only is she being raped by a man but she is stuck to him until the police or medical services remove the condom. She is completely at the mercy of a man who is likely to be extremely angry and as a result act in vengeance.

Also, this female condom with “teeth” does not address the issue that many women are in fact raped by lovers or potential lovers.

But at least someone is trying to find a solution to this problem. Since the incident I experienced I run with a taser and pepper spray, and this helps me feel not completely defenceless as I previously was. If the female condom with teeth helps to make some women feel safer, then let them wear it.