Over the past decade a great deal of attention, research and funds have been dedicated to the development of new HIV prevention technologies including male circumcision, microbicides, and vaccines. Yet it sometimes appears as if the most effective and proven strategy to prevent the sexual transmission of HIV and other sexually transmitted infections (STIs) has seemingly fallen off the global agenda – condoms.
The recent CAPRISA trial using a tenofovir gel as a microbicide is promising but, at present, condoms are still the most effective tool in our prevention package. However, without an increased investment by governments and donors the substantial discrepancy between the number of male and female condoms needed and the number available will grow ever larger. This ‘condom gap’ is also reflected in IPPF’s service statistics. In 2009, 122 Member Associations distributed over 151.8 million male condoms – a rate of approximately one for every 28 people of reproductive age per year. Only approximately 580,000 female condoms were distributed – that’s only one for every 3,740 people of reproductive age per year.
Generating demand for - and ensuring the ready availability of - condoms and lubricants is seen by many as the cornerstone of a dual protection strategy. In line with IPPF’s goal of linking SRH and HIV, the accessibility of male and female condoms helps prevent both unintended pregnancies and HIV. In many countries – particularly those with generalized HIV epidemics - this is surely the most basic of all solutions. In an environment of scarce resources this ‘back to basics’ approach for a renewed and re-energized focus on comprehensive condom programming needs to complimented by a sound strategy to ensure that the information given translates into practical accessibility for a variety of groups including young women and girls, men who have sex with men and people living with HIV. Advocates for the female and male condom, SRH and HIV programme managers, social marketing agencies and donors should ensure that, irrespective of other competing priorities, condom provision is not compromised. It should be a measure of real organizational and political commitment. No longer should we allow our collective attention to be swayed by a new or sexier topic while work on this basic provision remains to be done.
Pitting prevention against treatment is not a useful argument as both are mutually re-enforcing of each other. At IPPF we have an ever increasing and important role to play to ensure that every sexually active person has access to good quality condoms whenever and wherever they are needed, is motivated to use them appropriately, and has the knowledge to use them correctly. Maybe it is time for us to lead a stronger, sexier condom campaign, one which focuses on pleasure and creates demand for both male and female condoms, as well as lubricant.
Article from IPPF HIV Update newsletter - Issue 23: http://www.ippf.org/en/Resources/Newsletters/HIV+Update+Issue+23.htm
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