HIV prevention education and condom

HIV prevention education and condom promotion must overcome the challenges of
complex gender and cultural factors.
Young girls and women are regularly and repeatedly denied information about, and access
to, condoms. Often they do not have the power to negotiate the use of condoms. In many
social contexts, men are resistant to the use of condoms. This needs to be recognized in
designing condom promotion programmes. Female condoms can provide women with more
control in protecting themselves. However, women will remain highly vulnerable to HIV
exposure, until men and women share equal decision-making powers in their interpersonal
relationships.
Condoms have played a decisive role in HIV prevention efforts in many countries.
Condoms have helped to reduce HIV infection rates where AIDS has already taken hold,
curtailing the broader spread of HIV in settings where the epidemic is still concentrated in
specific populations.
Condoms have also encouraged safer sexual behaviour more generally. Recent analysis of
the AIDS epidemic in Uganda has confirmed that increased condom use, in conjunction with
delay in age of first sexual intercourse and reduction of sexual partners was an important
factor in the decline of HIV prevalence in the 1990s5. Thailand’s efforts to de-stigmatize
condoms and its targeted condom promotion for sex workers and their clients dramatically
reduced HIV infections in these populations and helped reduce the spread of the epidemic to
the general population. A similar policy in Cambodia has helped stabilize national
prevalence, while substantially decreasing prevalence among sex workers. In addition,
Brazil’s early and vigorous condom promotion among the general population and vulnerable
groups has successfully contributed to sustained control of the epidemic.
Increased access to antiretroviral treatment creates the need and the opportunity for
accelerated condom promotion.
The success of antiretroviral therapy in industrialized countries in reducing illness and
prolonging life can alter the perception of risk associated with HIV6. A perception of low-risk
and a sense of complacency can lead to unprotected sex through reduced or non-consistent
condom use. Promotion of correct and consistent condom use within antiretroviral treatment
programmes, and within reproductive health and family planning services, is essential to
reduce further opportunities for HIV transmission. Rapid scale-up of HIV testing and
counselling is needed to meet the prevention needs of all people, whether they are HIVpositive
or negative.