According to The Joint United Nations Program on HIV/AIDS (UNAIDS), in 2008 young people aged 15-24 years accounted for 42% of new HIV infections and nearly 80% of this live in sub-Saharan Africa including Ethiopia [1]. This situation makes it necessary to advance prevention actions directing women: female condom is a good option. According to World Health Organization (WHO) estimates, as of mid-2014 there were 18.7 million HIV-positive-women. Compared to 2004 the women living with HIV in 2014 have increased by over one million. In Sub-Saharan Africa 59% of infected adults are women.

This situation makes it necessary to increase measures of prevention which targets women, favoring empowerment and providing innovative preventive tools. The female condom allows women to choose a barrier method of protection against both unwanted pregnancies and Sexually Transmitted Infections (STIs), therefore constituting a valid alternative to the male condom [2].

According to Adetokunbo [3], explained that if a man can use a male condom, nothing should stop a woman from being able to use a female condom. Many people were not even aware of the female condom existence and in a situation the man did not want to use a male condom; they could as well resort to the use of female condoms. He further explained that many women were not aware of the existence of female condom and ensuring its successful use required prior practice of its insertion in a woman.

Interviewed participants on the streets of Johannesburg and discovered that some participants were not aware of it whereas those who were aware of it, have never seen it, let alone using it. It then clearly shows that this significant tool in the war against the spread of HIV/AIDS is not widely or easily accessible to participants, hence we still see the growing rate of teenage pregnancies in our societies (Personal communication, N. Sithole, May 15, 2010)

Walter Sisulu University participants cannot be viewed with exception to the general problem manifesting itself in the form of the spread of HIV/AIDS. It also cannot be regarded as immune from social economic effects surrounding the spread of HIV/AIDS in the country and the world at large. It is therefore against that background and in that very context that HIV/AIDS is not uncharacteristic of WSU student community (Personal communication, N. Sithole, May 15, 2010).

If the problem among the participants of Walter Sisulu University would be limited only to HIV/AIDS, such would be a significant symptom of missing the point. Every year there is a significant number of student teenagers who get pregnant and not necessarily one pregnancy per student in the term of study, to some it would even go up to two pregnancies per study term. Manifestation of pregnancy is directly consistent which the lack of protected sex which participants engage in. In other words, a picture of young participants who get pregnant in the institution of education, such is a call for attention as it clearly prints out that condoms are not consistently used [4].

This research project was informed by the above backdrop hence its focus was on studying the knowledge and use of female condoms and to further recommend to the institution to include female condoms in its campaigns against the spread of HIV/AIDS and unplanned pregnancies.

Research methodology provides the route map on the description of the participants used in the study; the measures that were used in the collection of data and the procedures followed as well as the analysis applied in the data.

Population and sample

The population for the present study was male and female participants in Walter Sisulu University Nelson Mandela Drive (NMD) campus. A simple random sampling was used in selecting participants who participated. Participants were 50 participants; 25 females and 25 males. The focus was on participants who are staying in the residences.

Research method and technique

This study used quantitative research method and the technique used was survey. The instrument utilized was a questionnaire which was constructed by the researcher. The questionnaire included closedended questions which measured knowledge, use, attitude, accessibility of female condoms and acceptance by love partners. Reliability and validity was checked during the pilot phase. According to Bless and Smith [5] reliability is the ability of the instrument to produce the same results if used in a similar context and validity is the ability of the instrument to measure what it intends to measure.

Procedure of data collection

A covering letter which informed the participants of the significance of the study was obtained from the relevant department and it also assured them of the confidentiality and anonymity of the information they gave. The questionnaires were given to the participants at their rooms in respective hostels. The explanation about the content of the questionnaire was made at the time of the delivery of the questionnaire. To allow the participants to respond to the questionnaire at a time comfortable to him/her, questionnaires were collected later at a time agreed upon by the participant.

Method for data analysis

The data was technologically analyzed through a Statistical Package for Social Sciences (SPSS), version 21.0. This computer program summarized the data and compile appropriate tables. It also draws graphs and shows the relationship between variables.

The purpose of the study was to investigate knowledge, attitude and use of female condoms by participants at Walter Sisulu University (NMD). This section is going to present the findings in the form of the tables.

Distribution of participants by the institution of study

Table 1 indicates that the frequency of 50 (100%) participants is all students at Walter Sisulu University, NMD campus.

Table 1: Participant's institution.

Table 2 indicates how the questionnaires were distributed. 36 (72%) of the participants who received questionnaires were in level 1 of study, 6 (12%) out of 50 participants were at the 2nd level of study and 8 (16%) were participants in the 3rd level of study. And the total number of participants used is 50 which makes 100%.

Table 2: Participant’s level of study.

Table 3 indicates that 25 (50%) of respondents who participated in the study were females and another 25 (50%) of respondents who participated were male participants. The frequency of all respondents participated is 50 which is equals to 100%.

Table 3: Participant's gender.

Table 4 indicates that 47 (94%) of participants once heard about female condoms while only 3 (6%) out of 50 respondents have never heard of female condom. The total number of all participants participated is 50 which is equals to 100% of participants responded to the question.

Table 4: Have you ever heard of female condoms?

In the Table 5 48 (96%) participants once seen the female condom and 2 (4%) has never seen it before. The number of participants who responded yes to the question above were 48 and those who responded No were only 2. The total number of participants participated and responded were 50 participants.

Table 5: Have you ever seen a female condom before?

Table 6 demonstrates that the frequency of 47 out of 50 (94%) participants know only one type of female condom, 2 out of 50 participants (24%) know two types of female condoms and then 1 out of 50 participants (2%) of them doesn’t know any type of female condoms. The total number of participants is 50 (100%).

Table 6: How many types of female condoms you know of?

Table 7 indicates that 1 (2%) out of 50 participants do know the difference and the frequency of 49 (98%) respondents doesn’t know the difference between the types of female condoms. All 50 (100%) participants responded to the question.

Table 7: Do you know the difference between the types of female condoms.

Table 8 demonstrates that a total number of 28 (56%) respondents know how to insert female condom, 10 (20%) out of 50 respondents do not know how to insert female condom whereas 12 (24%) out of 50 participants are not sure on how to insert the female condom. 50 (100%) demonstrates the total number all participants who participated in the study.

Table 8: Do you know how female condom is inserted?

Table 9 indicates that 11 (22%) out of 50 participants know how to dispose the female condom, whereas 24 (48%) respondents do not know how to dispose it and then 15 (30%) out of 50 respondents are not sure on how to dispose the female condom. 50 (100%) demonstrate the total number of participants and all of them responded to the question.

Table 9: Do you know how female condom is disposed?

Table 10 indicates that 2 (4%) out of 50 participants agree that female condom can be re-used, 33 (66%) participants disagree that it can be re-used. 14 (28%) of respondents do not know whether it can be re-used or not.

Table 10: Can you re-use a female condom?

49 (98%) is the total number of all participants who responded to the question asked. 1 (2 %) of participants did not give response to the question. 50 (100%) demonstrate the total number of participants.

Table 11 indicates that 5 out of 50 (10%) participants once used female condoms and 45 (90%) of them have never used the female condom. 50 (100%) demonstrate the total number of participants who participated in the study.

Table 11: Have you ever used a female condom?

Table 12 shows that 12 (24%) of participants have thought of using female condom, 33 (66%) out of 50 participants never thought of using the female condom. 90% is the total number of both the participants who have responded to the question. 5 (10%) out of 50 respondents did not respond to the above question. 50 (100%) demonstrate the total number of participants in the present study.

Table 12: If not have you ever thought of using it as an alternative to a male condom?

Table 13 indicates that 2 (4%) out of 50 respondents uses female condom twice a week, 1 (2%) uses it once a week, 1 (2%) uses it once in two weeks, 3 (6%) uses it once in three month, 19 (38%) have never used it.

Table 13: If an answer is yes to the above question, how often do you use a female condom?

26 (52%) indicates the total number participants who responded to the question and then 24 (48%) indicates those who did not provide an answer to the above question. 50 (100%) demonstrate the total number of participants.

Table 14 indicates that 2 (4%) of participants last used female condom this week, 2 (4%) out of 50 participants last used female condom last month, 1 (2%) last used it last year 2015, 2 (4%) last used it years ago and 39 (78%) never used it at all and the total of all participants who responded to the question is 46 (92%). Then 4 (8%) out of 50 participants have not answered the question. 50 (100%) demonstrate the total number of participants who participated in the study.

Table 14: When was your last time using a female condom?

Table 15 indicates that 11 (22%) out of 50 respondents strongly agree that female condom is a perfect Female-controlled alternative tool to male condom, 12 (24%) of respondents agree, 23 (46%) of participants are not sure whether it’s a perfect female-controlled alternative preventative tool to male condom or not, 2 (4%) out of 50 respondents disagree if it is and then 2 (4 %) strongly agree that it is a perfect female-controlled alternative preventative tool to male condom. 50 (100%) demonstrate the total number of participants who participated and responded to the question.

Table 15: Female condom is a perfect female-controlled alternative preventative tool to male condom.

Table 16 indicates that 6 (12%) out of 50 participants have a very good attitude towards using a female condom, 13 (26%) have a good attitude, 21 (42%) out of 50 participants are rating their attitude as fair towards using female condom, 2 (4%) are rating themselves as having a bad attitude and then 8 (16%) out of 50 participants are having a very bad attitude towards using a female condom. 50 (100%) shows the total number of participants who participated and responded to the question.

Table 16: How do you rate your attitude towards using a female condom

Table 17 indicates that 4 (8%) of participants rate the availability of female condoms in their villages or township as very good, 9 (18%) participants rate the availability as good, 9 (18%) rate it as fair, 10 (20%) out of 50 participants rate the availability in their village as the poor, 7 (14%) rate the availability in their village as very poor and then 11 (22%) of participants says female condoms are not available at all in their communities. 50 (100%) shows the total number of participants who participated and responded to the question.

Table 17: Rate the availability of female condoms in your home village or township.

Table 18 indicates that 6 (12%) of participants rate the availability of female condoms in their institution as very good, 11 (22%) rate it as good, 8 (16%) rate it as fair, 10 (20%) rate it as poor, 5 (10%) out of 50 participants rate the availability of female condoms in their institution as very poor and lastly 10 (20%) of participants are of the view that female condoms are not available at all in their institution. 50 (100%) shows the total number of participants who participated and responded to the question.

Table 18: Please rate the availability of female condoms in the institution.

Table 19 indicates that 8 (16%) of male participants are willing to use female condoms, 41 (82%) are not willing to use it and 1 (2%) did not answer the question. 50 (100%) shows the total number of participants who participated and responded to the question.

Table 19: According to your understanding are males willing to use female condoms?

Table 20 indicates that 5 (10%) out of 50 participants say yes men do suggest the use of female condoms and 45 (90%) out of 50 shows that men do not suggest the use of female condoms. 50 (100%) shows the total number of participants who participated and responded to the question.

Table 20: Do men suggest the use female condoms?

This study was to determine number of things regarding the female condoms in WSU-NMD. Among other things is the extent to which the participants know, use and access female condom where they live, be it in the compass or at home. Their attitude has been determined also including that of male partners. Below are the discussions on the matter.

It is interesting to note that participants are aware of the existence of female condoms as a significant number of them indicated that they heard about female condoms, which might be through media, friends and different sorts of awareness campaigns which take place at the campus. It became also clear that they do not know much about female condoms hence many of them do not know more than one, whereas there are two major types of them. Consistent to that they do not know the difference between female condoms. However, an average number of them indicated the knowledge regarding the insertion which might be due to learning about it when people are made aware of female condom. Kouame [6] suggested that several participants’ comments to the study conducted, is that the lack of knowledge was a primary obstacle. Others provided the same reason, lack of personnel is another tricky issue (knowledgeable people) [1] support by saying sexual risk behaviors remain a significant problem predisposing university students for STIs and HIV infection. Studies show that the special vulnerability of the youth in universities result from unsatisfactory knowledge, low risk perception, cultural difference, females low negotiation skills in condom use, widespread substance use and peer pressure towards STIs and/HIV.

Use of female condoms

Most of the participants have never used female condom, very few of them indicated that they once used them. An interesting part is that a majority of them do not even think of female condoms as an alternative to male condom. The lack of use might be due to little knowledge they have about female condoms.

Adetokunbo [3] states that some women regard female condom as nuisance to put on because it interrupts the sexual experience, thus destroying spontaneity and interfere with sensation during sexual intercourse. He further concludes that, thus negative perceptions may help to account for the low rate of usage of female condoms. Kress (2003) supported the above statement and said, talking about sex and use of condom is taboo to other religions. He further mentioned that “There has been some movements among faith communities to promote HIV/AIDS awareness programs and support condom use among married couples, but this is as far as it goes” [6].

Attitude towards female condom

An average number of participants indicated that they have generally positive attitude towards female condoms as very few of them indicated that they dislike female condoms. Nevertheless, they do not regard female condoms as an alternative to male condom which can increase women’s control on sexual activates. Agbiboa [7] indicates that female participants are divided when it comes to their attitudes towards female condoms. One group has positive attitude towards female condoms when another group has negative attitude. He also points that a good attitude is needed for participants to be motivated to use female condom. If students continue to have negative attitude and engage to unprotected sex, the first sexual event has clear adverse outcomes on health such as unplanned pregnancy for the women and STIs including HIV/AIDS [1].

Availability of female condoms

Consistence to participants’ lack of knowledge of female condoms is witnessed in the availability of female condoms where participants live. Most of the participants indicated that female condoms are not available in the Walter Sisulu University (NMD Campus). They also have the same feeling regarding the availability and accessibility of female condoms where they live, be it at their villages or in townships. According to Cecil, Perry, Seal, & Pinkerton, [8] even though it is over 15 years after the launch of the only female-controlled preventative against HIV, it is still largely marginalized and inaccessible, especially in sub-Saharan Africa. This indicates that the university students are exposed to health hazards through their sexual risk behaviors which consequently continuing to the spread of STI and HIV transmission [1,9].

Limitations of the study

The study is limited in terms of the respondents used. Only 50 respondents could be arranged.

The study was limited to one institution only. Due to unwillingness of respondents to provide information. The respondents filled the questionnaire casually and that affected the conclusion [10].

The busy schedule of respondents affected the commitment in answering the questionnaire fully and satisfactory [11].

The aim of the study was to investigate the knowledge and use, participants’ attitude and acceptance of female condoms at Walter Sisulu University (NMD). In all these areas it became clear that despite the role the government has played in educating people about female condoms, a lot still needs to be done especially here in Walter Sisulu University (NMD) so that participants’ knowledge and understanding can improve. This will help in the reduction of student-teenage pregnancies, STIs infection and HIV/AIDS infection rate in Walter Sisulu University (NMD) and the University at large. According to AVERTing HIV and AIDS, one should never use a male condom in addition to a female condom. The friction could cause both birth control methods to break and fail.

The researcher thanks Walter Sisulu University participants for their co-operation and participation in the study.

Prof. S.K. Mfusi (the supervisor) his advice, ideas, criticisms that were so helpful and constructive gave me strength and helped me a lot in the completion of this study.

Lastly Special thanks to Walter Sisulu University for their support in the completion of this study.