Paper by Anthony Odoh
Some time ago, I met a friend who had just come back from the National Youth Service Corps (NYSC) camp in Borno State. He had thoroughly enjoyed the vagaries of camp life and was eager to share his experience with me. At a point, however, he got a bit upset. Some representatives from UNICEF, he informed me, had come to the camp to address the corps members. His complaint: “They could not even bring some paracetamol for our headaches and pains from the drills; they only bombarded us with condoms…” This is indeed a sorrowful trend in the fight to curb the HIV/AIDS epidemic which has been ravaging the world for more than 2 decades now. According to the estimates from the Joint United Nations Programme on HIV/AIDS (UNAIDS) and the World Health Organization (WHO), 37 million adults and 2.5 million children were living with HIV at the end of 2003. This shows more than 50% higher values than those projected by WHO in 1991 using the data available then. In 2003 alone, some 5 million people became infected with HIV. At the end of 2005, an estimated 38.6 million people were living with HIV, with 4.1 new infections and 2.8 million deaths. In Nigeria, a greater percentage of HIV transmission results through sexual intercourse. The concomitant presence of Sexually Transmitted Diseases/Infections also increases the risk of spread since a disrupted skin surface offers a wider portal of entry for the virus.
Putting the Condom to the Test
Condom production and distribution has also become commonplace today. The subtle message being passed across is that we are likely not to exercise self-control in the use of our sexual powers. The alternative, the “safety catch”, we are told, is “if you can’t hold body, use the condom”. Another slogan that is often mouthed is “With condom, I dey kampe”. The condom is thus lauded as a sure prophylactic, an easy escape route out of responsibility for sometimes living a loose life. How does this affect your life and mine? Why does the rate of spread of HIV still increase despite repeated “successes” recorded in getting more people to use the condom?
It may be difficult to convey the various misconceptions about the condom and its effectiveness as a preventive measure for sexually transmitted infections as well as for HIV/AIDS but a joke I once heard may just be able to pass across the message: An armed robber enters a house, holding a gun and a syringe containing HIV-filled blood. He orders the house-owner to bring out all the money in his home under pain of being injected with the virus. The latter asks for permission to enter his room for a few minutes before making his decision. Coming out afterwards, he asks for the injection to be administered. When the robber had duly carried out his threat and left, the house owner burst out laughing, “Yeye armed robber, he didn’t even know I went into the room to put on a condom…”
Groups like the UNICEF, the International Planned Parenthood Federation and the Society for Family Health which do an extensive job of pushing for the use of condoms, do so with the conviction that condoms are actually a panacea to the HIV problem. They bank on reports about the efficacy of condom which seem to give a near-100 percent mark to the condom. The Centre for Disease Control (CDC) in America, stated in July 1999 that “condom manufacturers in the US test each latex condom for defects, including holes, before it is packaged” They insist that for condoms to provide maximum protection, they must be used consistently (every time) and correctly and that studies have shown that a “properly used latex condom provides a high degree of protection against a variety of STD, including HIV infection” (italics mine). In 2001, they stated that when used correctly all the time, “condoms prevent most STI’s including HIV” (italics mine). All this sounds reassuring, doesn’t it? Well, not quite, not after you put other factors into consideration.
If we are truly concerned about our lives, we should want to know what is actually meant by a “high degree of protection”. Life is so precious and cannot be repeated after one passes on. It is fraught with risks but even a gambler knows the limits he can broach especially when the stakes are very high. In July 2001, the National Institute of Health (NIH) of the United States Government released its report on the “Scientific Analysis on Condom Effectiveness for STD prevention”. The report, which is an analysis of 130 studies conducted over some decades, differentiates between condom efficacy (the protection which the users would enjoy under ideal conditions, this depending primarily on the properties of the condom) and condom effectiveness (protection offered under actual usage; dependent on the characteristics of the device and its user). The conclusions of the report? Apart from Gonorrhea (in men and not for women) for which there was some risk reduction, condom use for Chlamydia, trichomoniasis, chancroid, syphilis, genital herpes and Human papilomavirus showed no clinical proof of effectiveness from the available studies (more studies are necessary to determine its effectiveness).
According to the studies, “condoms provided an 85% reduction in HIV/AIDS transmission risk when infection rates were compared in always versus never users”
What about the remaining 15%? Is that percentage alright for you? Since the condom has not been sufficiently proven to be effective in preventing some of the common STDs listed above, there is an added risk of infection with HIV if there is an STD present. In view of the findings of the report, the CDC has made some changes in its fact sheet, which says amongst other things that “The surest way to avoid transmission of sexually transmitted diseases is to abstain from sexual intercourse, or to be in a long-term mutually monogamous relationship with a partner who has been tested and you know is uninfected. For persons whose sexual behaviors place them at risk for STDs, correct and consistent use of the male latex condom can reduce the risk of STD transmission. However, no protective method is 100 percent effective, and condom use cannot guarantee absolute protection against any STD … In order to achieve the protective effect of condoms, they must be used correctly and consistently. Incorrect use can lead to condom slippage or breakage, thus diminishing their protective effect. Inconsistent use, e.g., failure to use condoms with every act of intercourse, can lead to STD transmission because transmission can occur with a single act of intercourse”