Condoms: Always in fashion

Dr V Sam Prasad, Country Program Director, AIDS Healthcare Foundation, on the occasion of International Condoms Day, emphasises on intense public awareness campaigns to tackle the inhibitions and taboos associated with condoms and to encourage the use of condoms

The history of condoms goes back at least several centuries, and perhaps beyond. For most of the time, condoms have been used both as a method of birth control, and as a protective measure against sexually transmitted diseases. Prior to the 19th century, condoms were made from a variety of materials like chemically treated linen and animal tissue (intestine or bladder). Rubber condoms gained popularity in the mid-19th century, and in the early 20th century through the technical advances made in its manufacturing. In the second half of the 20th century, the low cost of condoms contributed to their importance in family planning programmes throughout the developing world. Condoms have become increasingly important in efforts to prevent HIV. The oldest condoms ever excavated were found in a cesspit located in the grounds of Dudley Castle, England and were made from animal membrane, the condoms dated back to as early as 1642.

Social marketing
The National Family Planning Programme of India had introduced condom as one of the family planning methods in the late1960s. Condom was promoted as a family planning method through social marketing since its inception. With the increasing prevalence and incidence of sexually transmitted infections (STIs) including HIV/AIDS, condom was also promoted as a dual method for protection against both unintended pregnancies as well as sexually transmitted infections. Condoms were available in India since decades ago. It was accessible at a cost of 25 paise by a few wealthier populations while population growth rate was highest among the lower income groups. To meet the demand, International agencies extended their help and recommended “social marketing” of condoms. In 1968, 400 million condoms were imported as branded ‘Nirodh’. A distribution system was worked out which involved one-fourth free supply to health centres, and remaining three fourth for social and commercial marketing. The social marketing of condom had begun with the launch of ‘Nirodh’ condoms by the government in 1968. The strategy of social marketing was to promote condom in reducing barriers that facilitate behaviour change. Promotional activities were initiated through mass media (television, radio, print media) and interpersonal communication (health workers) to creating demand for the condom and, therefore, facilitating the social marketing strategy’s success.

National AIDS Control Programme’s Condom Promotion strategy focuses on two aspects: ensuring availability and creating demand for condoms.

The availability of condoms is addressed through three sub components of Condom Promotion Programme: Free Condom, Socially Marketed Condom (Paid-subsidised) and Female Condom.
Free Condoms are procured by Ministry of Health & Family Welfare and distributed by NACO/ SACS to High Risk Group (HRGs) through TI NGOs/ICTC/ART centres for HIV/AIDS Prevention. Socially marketed condoms are distributed by NACO through its Social Marketing Organizations (SMOs) under Targeted Condom Social Marketing Programme (CSMP). The programme focuses geographically on high prevalence and/or high fertility districts with additional emphasis on ensuring condom availability in HRG sites – vulnerable population intensive areas. The programme also focuses on expansion of condom availability of hitherto underserved areas such as rural markets and increasing the numbers and types of outlets stocking and selling condoms and make it a ubiquitous product.

However, during the current phase of the National AIDS Control Programme Phase IV the proposed targets of condom distribution has not been able to achieve as indicated in the report of the mid-term appraisal of NACP IV. In 2015 – 16 only 16 per cent of the target have been achieved in terms of condom distribution leaving the high risk and vulnerable population in situations where they don’t have access availability and affordability towards condoms.

Having said this, it may be noted that the Ministry of Health & Family Welfare, NACO has set aside Rs 756.6 crores (13 per cent) and later reduced it to Rs 582.75 crores (10.3 per cent) of Rs 5,679.06 crores for condom programming. However, the report also recommends the need for the programme to explore possibilities of additional resources from National Health Mission for condoms.

It was found that barrier to use condom included the embarrassment in buying condom and perception that condoms were for non-marital sex only and there is no need not use it in regular relationships.
International Condom Day seeks to promote the use of condoms as a means of preventing unwanted pregnancies and sexually transmitted infections (STIs). Condoms are thin rubber covers that a man wears on his penis during sexual intercourse as a contraceptive or as protection against STIs. Condoms are made from various materials such as latex, non-latex, lambskin and even female condoms. Condoms, latex and polyurethane versions, are the only method available to prevent transmission of STIs and HIV. Worldwide, around 4.4 billion condoms were used for family planning and 6.0 billion condoms for HIV prevention.

Raising awareness
International Condom Day is promoted by the AIDS Healthcare Foundation in an effort to reduce the spread of HIV through safe sex practices. Since its inception in 2009, it has been an informal observance celebrated in conjunction with Valentine’s Day. The use of condoms is for the only proven method for reducing the transmission of HIV and other sexually transmitted infections (STIs) during sex. The theme for 2015 was, “Condoms Are Cool”, and for 2016 was, “Wrap Your App!” and was observed in 31 countries simultaneously to carry out special messages for the young people globally. The theme of this year is “condoms are always in fashion” the feel-good inspiration to convey the message that safer sex through consistent condom usage is rewarding and exciting—and never goes out of style.

There is a dire need to continue intense public awareness campaigns to tackle the inhibitions and taboos that are associated with condoms and to encourage the use of condoms especially in India. India is set to become the youngest country by 2020!! Every third person in an Indian city today is a youth. In about seven years, the median individual in India will be 29 years, very likely a city-dweller, making it the youngest country in the world. India is set to experience a dynamic transformation. By 2020, India is set to become the world’s youngest country with 64 per cent of its population in the working age group. National adult (15–49 years) HIV prevalence is estimated at 0.26 per cent. India has the third largest HIV epidemic in the world with 2.1 million people estimated to be living with HIV.

AHF has branded and is promoting and distributing for free high quality condoms “Love Condoms” globally in 39 countries to all who need. AHF has been able to successfully launch global campaigns for love condoms with the theme “Love is the best protection.” This campaign was a great success when it also provided free HIV testing and helped the young people globally know their HIV status. AHF India is aggressively distributing these condoms to the young population and providing services related to HIV for complementing the government’s initiatives of prevention testing and treatment of HIV. It is also worthwhile to understand that over 99 per cent of the population is not infected and it is important to ensure that they remain uninfected. The only mantra is ‘Condoms’ or rather ‘love condoms’ the most reliable protection from STI/HIV. It is important that every youth of this country is aware and empowered to access, avail and afford condoms any time without facing any barriers. Condoms are and always should or rather will continue to be in fashion among the young people to prevent every incident of infection. Correct and consistent use of condoms is the most critical path towards achieving the Sustainable Development Goal 3 – Ending the AIDS Epidemic by 2030. AHF India Cares would like to make a clarion call to all the youth of India on this day of International Condoms Day (February 13, 2017) to come forward to use and prove that “condoms are always in fashion”!!!