More than 10 years have elapsed since the female condom became widely available, and it remains the only female-initiated means of preventing both pregnancy and sexual-ly transmitted diseases (STDs), including HIV infection. The female condom was developed as an alternative to the male condom, and it was hailed as a method that would enable women to have greater control over their own protection from disease. With the support of theJoint United Nations Programme on HIV/AIDS (UNAIDS), public and private funders, and the manufacturer, more than 90 de-veloping countries have introduced the method through public distribution, social marketing campaigns or com-mercial outlets. In several countries that have actively promoted its use, such as South Africa, Brazil, Ghana and Zim-babwe, steadily increasing female condom sales to the government suggest that effective programs can generate demand.

At the same time, there have been disappointments. Uptake in the West and in some developing countries has been lower than was initially anticipated, demonstrating that successful introduction will not be as straightforward as was hoped. 1 The study by Kulczycki and colleagues2 in this issue of Perspectives on Sexual and Reproductive Health shows that the method is not popular among some women. Indeed, there are still gaps in knowledge about how acceptable the female condom is for long-term use and whether promoting it can help reduce STD rates. Despite both successes and disappointments, the female condom remains important to promote, especially in the face of heterosexually acquired HIV infection rates that are soaring globally. It is unfortunate, therefore, that a discourse has emerged recently that marginalizes the female condom as a viable prevention option, out of concerns about its high cost and the need for women to obtain their partner's cooperation in order to use it. 3 Such a conclusion is premature, as the picture is far more complex. In this viewpoint, we review what has been learned about the female condom over the past decade, and argue for a renewed commitment to behavioral intervention research and the implementation and evaluation of large-scale female condom programs.