However, they were occasionally faced with difficult negotiations with some clients, refusal to use the female condom and sexual violence. Despite the limitations, the studies found female condoms to be acceptable to certain groups of women, especially prostitutes. The acceptability of the female condom among women other than prostitutes faces two obstacles, the reaction of the woman's regular partner and attitudes to the device itself appearance, difficulties or uneasiness concerning its use. Despite these limitations, most studies concluded that the women who participated in the trials generally found the female condom acceptable. It has been shown to be effective against STD and HIV transmission in vitro but there is only limited evidence of its efficacy in vivo.
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Two studies have investigated the contraceptive effectiveness of the female condom, and it was found to be as effective as other barrier methods. This work discusses the female condom and the context of women's lives in sub-Saharan Africa, analyzes results of studies on acceptability conducted in Africa, and assesses the prospects for future use of the method in Africa.