Why are South Africans not using condoms?
By Dr Bulumko Futshane, Beyond Zero’s programme director
South Africa consistently focuses on reducing sexually transmitted infections (STIs) and yet despite best efforts, South Africa has the world’s greatest HIV burden. More than 7.7-million people were living with the disease. Condoms are highly effective for preventing sexually transmitted infections, most importantly, HIV. Why then do we have such high rates of infection, why don’t South Africans use them as they should?
The answer lies in the awkward conversations around negotiating the use of condoms and the power dynamic that exists between sexual partners. There is also a belief that using condoms promotes promiscuity particularly in marriages and with teens. Some may even dismiss the efficacy of using condoms because it ruins the moment and men may struggle to put on a condom correctly. The other deterrent is the issue of condoms reducing sensation during intercourse. We cannot discount the impact of patriarchy as women are not empowered to speak up and express their needs effectively.
There are numerous benefits to using condoms and the responsibility rests on both, males and females. Female condoms have many of the same advantages as male condoms.
The use of condoms is effective in maintaining women’s health; in the prevention of unintended pregnancy as well as against sexually transmitted infections like gonorrhea, chlamydia, and trichomoniasis. Condom use is also associated with a lower rate of certain diseases such as cervical cancer, pelvic inflammatory disease, infertility and HPV-associated disease.
HIV prevalence is high in key populations who are drivers of the spread of HIV/Aids; men who have sex with men (MSM), transgender (TG) and adolescent girls and young women. The spread of HIV infections, teen pregnancies and reproductive health diseases could be reduced if we all developed a habit of using condoms during sexual encounters.
It is vital that sexually active youth have access to condoms to protect their health and their lives. Teenage pregnancies remain a serious health and social problem in South Africa. Not only does it pose a health risk to both mother and child, it also has social consequences, such as continuing the cycle of school dropout leading to poverty. 10.9% of recorded births were to mothers aged 10 to 19 in South Africa, and 45% of maternal deaths during childbirth were teenagers.
Condoms are the only contraceptive method that can protect against both pregnancy and sexually transmitted infections. It is also most effective in preventing HIV transmission, when used during vaginal, oral or anal sex. The most effective results occurs when condoms are used consistently. The risk of pregnancy or contracting sexually transmitted infections is greatest when condoms are not used correctly with every act of sex.
Consistency and the correct use of condoms ensures 98% effectiveness in preventing pregnancy and prevents 80% to 95% of HIV transmission that would have occurred without condoms.
While condoms are not fool proof, they are effective, cheap, easy to use and freely available from public health clinics and hospitals. Beyond Zero’s outreach programmes demonstrate the correct way to use condoms and offer free condoms and HIV testing.
While not having any sex is the best way to remain safe, condoms offer by far the best protection for anyone who is sexually active and wants to practice safer sex.
Clearly, it is time to get over any condom phobia and take advantage of the health benefits of this deterrent to HIV/Aids and other diseases.
Beyond Zero NPC is a registered section 21 (NPO), delivering public health systems strengthening programmes in South Africa focussing on HIV and AIDS, STI care, TB care, patient support, treatment, and prevention. Striving for a future beyond zero new HIV infections, Beyond Zero leads and provides strategic management, oversight, monitoring and evaluation on the implementation of the Global Fund grant for April 2019 until March 2022.
Key focus areas of delivery include:
- Prevention programmes for adolescents and youth, in and out of school.
- Comprehensive prevention programmes for men who have sex with other men
- Comprehensive prevention programmes for the transgender community
- Community response and systems
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