By Darryl Fears
Washington Post Staff Writer
Saturday, March 6, 2010; A01
The District will become the first city in the United States to distribute female condoms free, part of a project that will make 500,000 of them available in beauty salons, convenience stores and high schools in parts of the city with high HIV rates.
City officials said the distribution could begin within the next three weeks in parts of wards 1, 2, 3, 6 and 7, where a study showed that large numbers of African American heterosexuals engage in risky sexual behavior that could easily lead to infection.
The move is an official acknowledgment of the futility of relying solely on the use of male condoms, which have been distributed citywide for nearly a decade, to stem the District's epidemic of HIV and AIDS. Officials said they are turning to female condoms to give women more power to protect themselves from HIV and sexually transmitted diseases when their partners refuse to use protection.
HIV/AIDS infection is the leading cause of death for black women 25-34 nationwide. A 2008 report showed the District's HIV/AIDS rate at 3 percent, or about 15,100 adults, a major epidemic.
"Anywhere male condoms are available, female condoms will be available," said Shannon Hader, director of the D.C. HIV/AIDS Administration. "We're not saying that if you're a school in this area, you can't get female condoms. We're trying to make every effort count to build on what already exists . . . to expand options rather than limit them."
The project is funded through a $500,000 grant from the MAC AIDS Fund, a subsidiary of MAC Cosmetics, which contributes to numerous city programs, including two of the city's needle exchange programs. The grant helped the city buy the condoms at wholesale prices from the Female Health Co. and provide them for distribution by social service organizations, including Planned Parenthood, the Community Education Group and the Women's Collective.
In recent months, the HIV/AIDS Administration came under scrutiny after a Washington Post investigation revealed that some groups with which it contracted to provide services failed to obtain business licenses and file tax returns. Others gave false information about employee résumés and consulting contracts, or spent lavishly on travel and executive salaries.
The U.S. Department of Housing and Urban Development threatened to withhold $12.2 million in federal funding but released the money after the District agreed to improve its tracking of spending by AIDS programs and monitor the services they deliver.'Get with the program'
Hader said her agency is working to fix its problems while moving aggressively to attack the city's disproportionate rate of HIV infection. She said staffs of community organizations are training to demonstrate how the condom should be used properly. One group is in talks with a hair salon on Martin Luther King Avenue in Southeast Washington to introduce the condom and provide instruction on its use there.
"There are areas where the city is not doing a good job [with AIDS], but in some areas they are cutting edge. On this one, they're cutting edge" said Walter Smith, executive director of D.C. Appleseed, a watchdog group. "The very fact that they're doing this . . . says to women of the city that this is important to you. This is important to your families. Get with the program."
Nancy Mahon, executive director of the MAC fund, said she approached Hader last year after the city released the statistics on its AIDS rate and asked: "If you could have a dream project here, what would it be?"
Hader thought of HIV/AIDS "hot spots" identified in the HIV Heterosexual Behavior Study, which was released in tandem with the epidemiological report. In the behavior study, 75 percent of participants said they were in committed relationships. But nearly half, 46 percent, said they thought their last sexual partner had had sex outside the relationship. And nearly half, 45 percent, said they had had sex outside the relationship.
More than 70 percent said they didn't use condoms, and only 60 percent said they had been tested for HIV. Hader and other health officials said they think the District's HIV rate is closer to 5 percent because many people might be unaware that they are infected.
Activists say poor women often are reluctant to protest when their husbands and boyfriends refuse to use male condoms because they are dependent on the man's income.
The female condom has been available in Europe for nearly two decades and was first approved for use by the FDA in 1993. Its use in the United States was limited and ineffective. Women complained that the first version, FC1, was too expensive, about $17 for a box of five, and unsatisfactory.New condom approved
Last year the Federal Drug Administration approved a second version, FC2, with a thinner polyurethane that conducts body heat and enhances sexual sensation for men and women, according to its designers at the Female Health Co. The new condom was developed in 2005 and became widely used in South Africa. It is now in use in nations such as Indonesia and Brazil.
Mahon and Hader entered into discussions with Mary Ann Leeper, senior strategic adviser for the Female Health Co. The company was in the process of contacting the health departments in cities with the highest rate of infection when the call came, Leeper said.
CVS became the nation's first pharmacy to sell the new condom after the group contacted the company, said Vernon Goad, CVS's field marketing manager in the Washington area. Goad said the pharmacy will offer the female condoms next to male condoms in all of its 56 city stores, not just in target areas. A package of three female condoms sells for $6.50. A three-pack of male condoms sells for $5 to $7.
The female condoms went on sale in December, but sales have been slow. "I don't think people are aware that we have them," Goad said.