Condoms

This week's episode of Siyayinqoba Beat It! looks at the impact of correct and consistent condom use on sexually transmitted infection (STIs), HIV and pregnancy rates. We first visit Khayelitsha near Cape Town, where a massive increase in condom distribution seems to be having a positive effect as HIV and STI incidence and teenage pregnancy rates have all decreased. We then head to the 2010 World AIDS Conference in Vienna, Austria where female condoms were high on the agenda. We learn about efforts to make female condoms more widely available and our CJs discuss their use with two young South African women.

In recent years Khayelitsha near Cape Town has been the site of a massive campaign to encourage correct and consistent condom use amongst the population. On average one million condoms are distributed each month - a huge increase over five years ago. At the same time health workers have noticed a 50% decline in the incidence of STIs. Our CJs accompany activists from the Treatment Action Campaign (TAC) as they go door-to-door distributing condoms and educating people about HIV and other STIs. When condoms become scarce because of shortages from the suppliers, as happened last December, other organisations like Medicine Sans Frontières step in to make-up the shortfall.

Dr Virginia de Azevedo, the City Health Manager for Khayelitsha, says the evidence of STI reduction is very positive and there is good reason to think that it is linked to increased condom use. STIs (such as Chlamydia and Gonorrhoea) soon develop painful symptoms so people come for treatment quickly (unlike with HIV). The rate of STIs is therefore an excellent indicator of how much unprotected sex is taking place. Working with TAC enabled the campaign to move out of clinics and reach men in the shebeens, sports centres, and taxi ranks where they gather. Mthuthuzeli Dutyulwa of TAC says that condoms are the best way to fight HIV because the youth will not abstain so it is vital to encourage condom use.

One question the TAC members often get asked during their rounds is whether female condoms are available. Many females are unable to protect themselves when their partners refuse to use condoms and female condoms are the only female controlled means of protection against STIs, HIV and pregnancy. However, female condoms are not readily available and the issue was a priority at the 2010 World AIDS Conference in Vienna, which was attended by Siyayinqoba Beat It! In her address to the conference, TAC General Secretary Vuyiseka Dubula called for people "to have access to treatment and prevention tools and services that respect their human rights, including sexual reproductive rights of women ..."

The conference featured exhibits of female condoms that are available or in-development. Some women though remain unconvinced. Speaking to two young women in Cape Town our CJs learned that many are put off by the appearance and feel of the available condoms and worry what men think of them. Unlike male condoms, female condoms are not cheap. Researchers hope that more innovation and choice in the range of female condoms available will make them both more appealing and more accessible. The evidence so far suggests that increasing condom use is the most effective way to reduce STI and HIV incidence as well as teenage pregnancies. Making female condoms accessible will strengthen this effort and reinforce the basic rights of women over their bodies.