By Neil Marks
In 2007, more than two million condoms were brought into Guyana.
Who is using them? Are they being used?
“They aren’t being used as balloons for sure,” Nazim Hussain quips. He is the Community Mobilisation Coordinator at the National AIDS Programme Secretariat (NAPS) in Georgetown, and goes across the country meeting with – and distributing condoms – to different groups, be they commercial sex workers, men who have sex with men, and youths.
He also works with religious leaders, helping last year with the process that led to the creation of the HIV and Faith Coalition.
As far as Hussain knows the condoms bought and distributed by NAPS through various Non Governmental Organisations and the private sector are being used.
“The kids don’t want to talk about abstinence, they want condoms!” Hussain declared. “They are having sex and they want condoms to have sex; the condoms are being used.”
The debate about the use of condoms and its effectiveness in the fight against the HIV/AIDS epidemic was resurrected last week when Pope Benedict XVI suggested that the distribution of condoms increases the problem.
The some 13,000 HIV professionals who make up the International AIDS Society (IAS) made no bones about saying that the Pope’s comments were “ignorant” and “irresponsible.” In fact, President of the Society, Julio Montaner, went as far as to say that the Pope’s statement was “dangerous.”
Reuben del Prado, who heads the Joint UNAIDS Programme in Guyana and Suriname, agrees with Montaner. But he goes further, suggesting that the Pope Benedict and the church should mind on their own business.
“The church is not to interfere in the business of condoms; their business is to deal with faith and the spirit.”
He argued that everything that happens in HIV has to be based on evidence. “Bring the evidence,” he asks of those who suggest that condoms perpetuate sexual activity and thus exposes many more to the risk of contracting HIV.
“If you carry an umbrella, you are not calling rain; you carry it for protection,” del Prado offered, saying that condoms don’t encourage sexual activity, but serve as protection against HIV for those who are having sex or contemplating sex.
He admits that in Guyana the church does not talk much about condoms, “there are hardly any outbursts.” However, when the Pope made his comments last Tuesday, UNAIDS in Guyana rushed to issue a statement in support of combination HIV prevention, including condom use towards universal access to HIV prevention, treatment, care and support, mindful of the effect it could have on the country’s 60,000 Catholics.
With more than 7400 new HIV infections each day the world cannot stop the AIDS epidemic without stopping new HIV infections, UNAIDS stated, saying that countries must know their epidemic and tailor their response to it.
In Guyana, the fight against HIV has managed to get the support of religious leaders from the predominant religions in Guyana, namely Hinduism, Islam and Christianity. While they might not out rightly advocate for the use of condoms, they do not discourage its use.
The IAS, whose president Julio Montaner is quoted above, noted that while the historic stance of the Roman Catholic Church against contraception use is widely known, Pope Benedict’s predecessor John Paul II never spoke out publicly against the use of condoms to prevent HIV infection.
“There is not a shred of evidence to suggest that condoms can increase HIV transmission – absolutely the contrary,” said Dr. Montaner. “Male and female condoms, used correctly and consistently, can reduce the risk of sexual transmission of HIV by 80-90 percent.”
Montaner argued that while condoms are not the only solution to combating HIV, they are a critical, cheap and cost-effective element of a comprehensive approach to HIV prevention.
“Instead of spreading ignorance, the Pope should use his global position of leadership to encourage young people, who are our future, to protect themselves and others from HIV infection using all the tools we have at our disposal, including condoms.
“His remarks are insulting to the tireless efforts of committed scientific, public health and human rights leaders around the world to protect the poorest of the poor from HIV infection,” Montaner declared.
The larger UNAIDS body, together with the United Nations Population Fund and the World Health organization were also alarmed at the Pope’s statement, pointing out that the male latex condom is the single, most efficient, available technology to reduce the sexual transmission of HIV and other sexually transmitted infections.
“The search for new preventive technologies such as HIV vaccines and microbicides continues to make progress, but condoms will remain the key preventive tool for many, many years to come.
“Condoms are a key component of combination prevention strategies individuals can choose at different times in their lives to reduce their risks of sexual exposure to HIV,” the organizations stated.
A Behaviour Surveillance Survey conducted in 2004 showed that out of school youths in Guyana reported a high level of condom use with sex workers, indicating that they see condoms as a safe way of preventing transmission of HIV.
Youths in school who were sexually active also saw condoms as a safe way of preventing the transmission of the disease.
The survey showed that there was a lower level of condom use with sex workers (some said they exchanged sex for money or other material things) than with noncommercial partners.
According to del Prado five years ago, when that survey was conducted, condom use was an issue, now it’s a non-issue, and people very open to asking for condoms or buying over the counter at supermarkets. The government imports condoms for free distribution.
In fact, Hussain said that many prefer the free condoms the government offers. In fact, to test this, Hussain said he once tried to sell condoms, but was repeatedly rebuked by persons who declared that condoms are distributed free of charge.
Dr del Prado credits Guyana’s successes in the fight against HIV to a robust condom distribution campaign, noting that the latest Behaviour Surveillance Survey points to a reduction in the prevalence rate among commercial sex workers.
An estimated 12,000 persons are living with HIV in Guyana, but with more accurate reporting, health officials have said this number could be significantly less.
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