Report on the Global HIV/AIDS epidemic

Report on the global HIV/AIDS epidemic - June 2000

It is especially important for young people to use condoms in high-prevalence countries where they are likely to encounter an HIV-infected partner at the start of their
sex lives. South Africa, one such country, offers good examples both of what can be
done to encourage young people to behave safely and of the challenges that remain.
In 1999, over three-quarters of all students in high schools in Johannesburg and in
tertiary institutions in Northern Province had used a condom the last time they had
sex, and nearly as many said they always used condoms. Unfortunately, in rural
areas in KwaZulu Natal, where over a quarter of pregnant women in their late teens
have HIV and where the probability of encountering an infected partner is probably
as high as anywhere in the world, the rates of condom use among young people
were three times lower than those elsewhere in the country. The study showed that
the use of condoms is far higher in places where condoms are easily and confidentially available to young people than in places where no special effort is made to
meet the needs of the young (see Box 13 below).
Box 13. Making the safe choice easier
Condoms must be widely and conveniently accessible if they are to be an easy
choice. In one South African study, around 85% of both men and women said that
use of condoms could prevent AIDS, and high proportions of the respondents had
multiple partners or believed that their regular partner was unfaithful, but over 60%
of both men and women had never used a condom. While half of all the men said
they intended to use a condom every time they had sex with a casual partner, only
16% of them actually did so. When asked why, many respondents said they simply
did not have a condom handy.
There has been impressive progress in improving the availability of condoms, for
example through social marketing - an approach which relies on the profit motive as
an incentive for vendors to purchase subsidized condoms and sell them at a small
mark-up.
For example, in the space of less than a year, a condom social marketing project in
Myanmar achieved an impressive increase in the accessibility of, and the demand for,
condoms. The quarterly sales of condoms in this project rose from 1 million in
October-December 1997 to 1.8 million in July-September 1999. Over the same
period, the cumulative number of retail outlets (both traditional and non-traditional)
for social marketing of condoms increased from 364 to 1500.
While programmes such as this operate in many countries, much still remains to be
done, especially for young people who may need particularly discreet access and
may not be able to afford even subsidized condoms.

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