Abstract
This study was conducted against the backdrop of the HIV and AIDS pandemic that continues to
threaten all facets of human lives. Globally, women and adolescent girls are the most affected
population. In the South African context, AGYW (adolescent girls and young women) between the
ages 15 and 24 years are disproportionately affected, some of whom are female students in higher
education institutions (HEIs). The introduction of the female condom (FC) by the South African
government in 1998 offered an opportunity for South African women to take charge of their sexual
and reproductive health rights and protect themselves against HIV infection. Despite the availability
of the FC, it has not translated into usage, especially in most HEIs where male condoms (MCs) are
reported to be running out faster than the FCs, yet it is the only female-initiated HIV prevention
technology with the potential to reduce HIV infections among young women. The low uptake of the
FC is conspicuous at the University of Venda (UniVen), which is in the rural areas of the Limpopo
Province. The study sought to investigate why there is an under-utilisation of the FC by female
university students at UniVen. Therefore, the prime aim of the study was to examine the perceptions
that female students attach to the use of the FC for HIV prevention. The study used insights from the
women empowerment theory as a building block to argue for the empowerment dimensions of the
FC. A qualitative methodology with a phenomenological approach was also used to study the female
students’ perceptions in their natural context. A dual methods approach, consisting of in-depth
interviews and a pledge-wall, was used for data collection. A total of 20 female students, who were
purposively sampled, participated in the in-depth interviews based on their participation in HIV and
AIDS dialogues and campaigns. The pledge-wall catered for the 51 conveniently sampled female
students who were not comfortable with participating in in-depth interviews. Data were analysed
thematically by extrapolating critical themes from in-depth interviews and the pledge-walls. Key
findings from the study showed that female students at UniVen downplay the use of the FC because
of low knowledge levels on its correct use and design-related features of the FC which discourage its
use. These range from its appearance, which is said to be unattractive, intimidating, scary, too big and
smelly, which demotivate FC use. These features make the FC a complicated, uncomfortable,
unpleasurable and an unsafe tool for young women, leading to its under-utilisation. It also emerged
that social factors prohibiting FC use range from the female students’ lack of economic power to
initiate condom use, to the challenge of patriarchy, tied to the aspect of rurality where female students
are discouraged from collecting condoms or initiating their use for fear of being labelled as loose
or tshifewe (bitch). Behavioural risk factors, such as having multiple concurrent relationships,
intergeneration sexual relations, alcohol and drug abuse as well as negative peer pressure, inhibit FC
use among female students at UniVen. However, a few female students applauded the FC for
empowering women, its durability, lubrication, and dual protection against unplanned pregnancies as
well as HIV and other STIs. The study contributes to the body of knowledge on user-based
perspectives on FC use in rural-based institutions of higher learning, which is an under-researched
area. The study's methodological contribution is on the use of a pledge-wall as a data collection
method when researching sensitive matters that participants may not be comfortable sharing in a faceto-
face engagement during in-depth interviews. The study recommended strengthening demand
creation strategies to increase knowledge levels and uptake of the FC. Considering the negative effect
of socio-culural aspects on FC uptake and use, there is an imperative for engaged scholarship for
awareness raising and sensitisation of traditional leaders of women’s sexual reproductive health and
rights (SRHR). Recommended also is the engagement of men since male partner resistance emerged
to be a barrier to FC uptake and use. Design-based challenges discussed in the study prompted
recommendations to redesign the FC to be user-friendly for its intended users and to raise knowledge
levels to boost the female students’ confidence in negotiating for safer sex using the FC. This should
include the young men in a rural university because men’s involvement in sexual and reproductive
health (SRH) matters is generally under-researched, yet they are critical players in making household
decisions, including safer sex and contraception practices.
Key words: HIV and AIDS, female students, female condom, South Africa, UniVen, rurality.