Doubts cast over condom campaign
June 05, 2005 Edition 1
Edwin Naidu
Aids experts are divided over whether the government's rapidly rising investment in the distribution of condoms is helping to prevent the spread of HIV/Aids.
The department of health distributed an average of 1 million male condoms a day last year, almost 400 million in total.
"Distribution is one thing, whether people are using the condoms is another," said Rob Stewart, the project manager for the Health Systems Trust.
The government's distribution of condoms rose dramatically from 150 million in 1997 to 270 million in 2003, an 80 percent increase, with the health department targeting 3 000 diverse places such as spazas, taverns and hair salons, in addition to traditional outlets such as clinics.
Stewart said, however, there was no recent study to gauge the effectiveness of the government's massive investment in condom distribution, as increasingly the focus in the battle against the pandemic had turned to treatment programmes, rather than prevention. "The government's prevention campaign has been found wanting," he said.
Stewart said a coherent national prevention strategy was urgently needed to complement the existing treatment plan.
Msanyana Sikhosana, the spokesperson for the Treatment Action Campaign in Mpumalanga, said the increase in condom distribution had not helped to curb the spread of Aids. "The government is not distributing condoms to schools where it is obvious teenage pupils are engaging in sexual activities," he said.
David Harrison, the chief executive of loveLife, said condom use had been effective in countries where there had been a concentrated epidemic. "Condom use is important when you have a general epidemic, but it is only part of a package of interventions," he said.
Harrison added there were at present two ways of gauging condom use: the last time a person had sex and the consistent use of condoms.
He said a loveLife survey of 11 000 youths in 2003 showed that 52 percent of youths between 15 and 24 used a condom the last time they had sex, while 33 percent said they always used one, 12 percent said more than half of the time, 11 percent less than half the time, and 31 percent, never.
"Since 1998 there appears to have been an increase in condom use," a person said, adding that a health survey then showed condom use to be less than 30 percent. "Now you are talking about 52 percent, while other surveys indicate it is up to 60 percent," he said.
loveLife focuses on teenage sexuality and relationships and the prevention of HIV infection through mass-media advertising, supported by a helpline, which offers services for young people.
Harrison said there was a still a problem in getting people to use condoms consistently, and the figures were currently low.
"Anything less than 90 percent of the population is not going to be effective, but we have made progress but not enough for us to see if it will lead to a major reduction of HIV infections in South Africa," he said.
Manto Tshabalala-Msimang, the minister of health, speaking at the launch of Choice condoms last June, said the quality and standard of condoms had been set by the South African Bureau of Standards.
"There is a widespread public perception that government condoms are of inferior quality compared to commercial brands that you buy in shops or pharmacies."
The minister said branding the condom "Choice" was the government's way of increasing and speeding up the impact of prevention strategies against sexually transmitted infections, including HIV/Aids.
She said South Africa had the largest fully funded government condom procurement programme in Africa. "Condoms should not only be a necessity but they should be seen as sexy and part of fun," she added.
