Thursday, May 21, 2009

Last Night, Condoms Saved Many Lives

IRIN (Integrated Regional Information Networks) had an article recently about Tanzanian bars and nightclubs getting condom vending machines soon. These machines would be placed in toilets as part of the national HIV prevention programme.

From reading HIV literature over the years, you would have thought there would already be dispensers in all bars, clubs, restaurants, hotels and anywhere else possible. But that is not the case. I have stayed in over 50 low budget hotels, eaten in over 100 restaurants, drunk in nearly as many bars and been to plenty of nightclubs and other places where people gather. And very few of them had an obvious supply of condoms.

Occasionally, when you are leaving a nightclub or late opening venue, you will find an enterprising stallholder outside, selling condoms. A little more frequently, you will see a box of condoms or even a selection of brands behind bars. I have little doubt that if you asked in some places you would get condoms.

Recently I stayed in a hotel and happened to open a drawer to find over 100 unbranded (donor supplied) condoms in an unmarked bag. Wonderful, except that they were manufactured in 2004 and will all expire in August.

But the problem is that people often don’t ask for condoms, for various reasons. And I’ve tried asking in some places, without success. As a result, people can be without condoms when it is too late to turn back. Or they are stuck with a vendor who only has expensive brands, so they don’t bother.

Condoms are too important to leave to chance. It’s true that they are an individual’s responsibility. But not everyone thinks of them at the right time; you can be taken by surprise and not everyone is as responsible as they should be. The Tanzanian programme is starting in Dar es Salaam, the commercial capital. But this is one place where you are much more likely to be able to find condoms, especially late at night. Let's hope the programme moves away from the capital to where the need for condoms and condom related education is far more urgent.

A young man who works for a HIV/Aids related community based organization recently told me that he thinks the only thing standing between Kenya and a far more serious HIV epidemic is condoms. He is a Muslim, a faith opposed to the use of condoms. But he works with people who are poor and marginalized. He knows a lot about why HIV spreads and he knows a lot about preventing it from spreading further.

It's not enough for people to be able to see the numerous signs and billboards about HIV and condoms, they need to be able to see the condoms, they need to know where to get them. And the times and places people are most likely to need condoms are no secret. People go to bars, clubs and other places to meet up with other people and have fun. Sometimes having fun involves having sex. Denying that this happens or arguing that it shouldn't happen is not going to prevent transmission of HIV, other sexually transmitted infections or unplanned pregnancies.

A reliable and accessible supply of condoms should become part of the country's national infrastructure. Yet, you still come across people who say they don't see them as much any more or you don't hear about them as much or they subscribe to one of the many myths about condoms not working or having holes in them that let viruses through. They do not have holes in them and they do work.

Of course they are not 100% safe. People say the only thing that is 100% safe is abstinence. The problem is that abstinence does not always work. People can have the best intentions but find themselves in a position where they are unable or unwilling to keep to them. The decision to abstain does not remove the possibility of circumstances and temptations.

I hope Tanzania and other African countries with a HIV epidemic, 'serious' or otherwise, make condoms more obviously available. This is one of the most important steps towards reducing transmission of HIV, sexually transmitted infections and unplanned pregnancies. To those who think that to promote condoms is to promote promiscuity I would say this: some people are promiscuous and until there is a feasible means of reducing promiscuity, condoms are one of the few things they have got to protect themselves from becoming infected and from infecting others with sexually transmitted infections.



Njoroge Matathia said...

Excellent Blog... happened on it today as I was checking out comments on testing in Kenya as background for a quick post I mean to do on my musings at a VCT center yesterday.

Will be back....

Njoroge Matathia
The Black Campaign

Simon said...

Hi Njoroge, thank you for getting in touch, I'd love to hear more about your project but you don't give much away on your blog! I'll have a look at your posts and look forward to hearing more. Regards, Simon