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Editorial
attacks shift away from condoms in HIV prevention
Michael
Carter
18
August 2003
http://www.aidsmap.com/news/newsdisplay2.asp?newsId=2253
In a direct attack on the Bush administration's
stance on HIV prevention, authors from a leading US
sexual health and family planning organisation asserts
that consistent use of condoms can reduce the risk of
HIV transmission in discordant couples to “near
zero" in an editorial in the August edition of the
journal Sexually Transmitted Infections. The
authors also note that although condoms are extremely
cost effective, their importance to HIV prevention seems
to have been forgotten in the push for global treatment
access, and that other substantial obstacles still exist
to effective condom distribution schemes.
The authors from Family Health
International (FHI) point out that only 3% of
presentations ar recent international AIDS conferences
have focused on condoms as an effective means of HIV
prevention, with seven times as many abstracts focusing
on treatment access. Although “the life saving benefit
of antiretroviral therapy is undeniable” the authors
note, “progress on treatment access must not come at
the expense of prevention…including condom use.”
”Condoms are effective for HIV prevention”
says the editorial, a forthright statement which
challenges the abstinence approach favoured by the Bush
administration in both its domestic and international
HIV prevention programmes. Consistent condom use can
reduce the risk of HIV transmission to “near zero”
stress the FHI authors, adding that “condom promotion
has been a critical component of all population level
HIV success stories to date.”
Even though condom distribution programmes,
particularly if targeted at high-risk groups, are highly
cost effective, substantial barriers still stand in the
way of the wide-spread availability of condoms. Not the
least of which is a reduction in the number of condoms
provided by donors in recent years, with no more condoms
provided to fight the spread of HIV in resource-limited
setting in 2000 than in 1990. Even where condoms are
available there can be important gaps in their
provision. For example, “in western Kenya clients of
sex workers indicated that they do not have access to
condoms in places where sexual encounters occurred”.
This problem also exists in other parts of Africa and,
“unfortunately, not nearly enough condoms reach the
region, hardest hit by HIV.”
What’s more “stigma, myth and rumour”
surround condoms, resulting in “low uptake and
inconsistent use.” Such myths and rumours condoms
being ineffective, having holes, or cause promiscuity.
This is another clear attack on the Bush
administration’s support for abstinence-only
programmes, which only mention of condoms relation to
their failure rate. This is despite the fact that when
used correctly, condoms have an extremely unlikely to
fail. Indeed, the authors stress, “condom
manufacturing and packaging processes have improved to
the point that the initial quality of most devices is no
longer questioned.”
The editorial concludes that “condoms are
efficacious” and urges donors to learn how to best
promote condom use as part of HIV primary prevention
packages.
Further information on this website
Condoms
and lubricants - menu of resources
Condoms
- factsheet
Reference
Feldlum PJ et al. Don’t overlook condoms
for HIV prevention. Sexually Transmitted Infections
79: 268 – 69, 2003.
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