Population Action International

Why Condoms Count in the Era of HIV/AIDS

June 1, 2004

Worldwide, more than 40 million people are living with HIV or AIDS, almost half of whom are women and one-third of whom are young people aged 15 to 24. The vast majority of HIV infections are sexual and therefore, preventable. Male and female condoms are essential components of prevention efforts, and expanding and improving condom promotion and distribution is key to fighting the spread of AIDS.

Why condoms, why now?

The condom is the only technology available for protection from sexually transmitted HIV. Scientists agree that the transmission of HIV during sexual intercourse can be prevented when condoms are used correctly and consistently.

AIDS is the leading cause of death in sub-Saharan Africa and the third leading killer worldwide. HIV, the cause of AIDS, continues to spread in every corner of the globe. Some 14,000 people become infected with HIV every day, and the vast majority of these infections are sexual. No one is immune.

Condom support doesn’t meet the need

The need for promotion and distribution of condoms still far outstrips the resources committed. An estimated 9.9 billion condoms were needed in 2002 to significantly reduce the rate of HIV infection and prevalence in the developing world and Eastern Europe. Donors provided 2.5 billion condoms that year, up from 950 million in 2000.

The doubling of donor funding resulted only from one-time contributions by the British, Dutch and Canadian governments to the United Nations Population Fund (UNFPA). More developing country governments are allocating resources for prevention, but national commitment generally remains inadequate.

Condoms in comprehensive programs

Condoms are necessary for the success of HIV/AIDS prevention efforts, but alone, they are by no means sufficient. Changing attitudes and behavior is at the heart of any successful prevention strategy. Such a strategy should establish the environments and conditions that allow people to protect themselves against infection. It should educate about sexual health and HIV transmission, and it should emphasize the benefits of delaying sexual debut for those who are not yet sexually active.

Societies must address the roots of poverty and gender inequities, including the unequal access of certain segments of society – especially of girls and women – to resources and opportunities that empower them to make the choices and decisions that affect their lives.

Overall success of HIV/AIDS prevention efforts depends on strong political leadership, appropriate funding, supportive policies and well-organized programs that work to influence attitudes and change behaviors and that provide the necessary services and supplies. In every arena, civil society actors, including non-governmental organizations, should be actively involved.

HIV/AIDS prevention programs must include a range and mix of interventions tailored to the specific needs of various groups and localities. This must include promotion of delayed sexual debut, abstinence, fidelity to one’s partner and correct and consistent condom use by the sexually active. Any range or mix of interventions should include condoms.

Key Recommendations

Male and female condoms should be available to everyone who needs them, whenever and wherever they want them. If cigarettes can get to the remotest corners of the planet, so can condoms. AIDS is everywhere, and the means for protection against the epidemic also must be everywhere.

More money, and its effective use, is key to making AIDS prevention programs successful. This includes support for condom promotion and distribution.

Unwavering commitment to preventing HIV is key to success in the war against the spread of HIV/AIDS. The international community, especially donor nations and institutions, must act quickly to mount large-scale comprehensive prevention efforts that strongly support the promotion and distribution of condoms. Failure to act is having tragic consequences already, particularly in sub-Saharan Africa, where 2.3 million people died of AIDS in 2003, and more than 25 million people currently live with the disease. These alarming statistics for Africa presage the future for some countries in Asia and other regions unless preventive action is intensified immediately.



How many condoms?

At least 18.6 billion condoms will be needed by 2015. The UNFPA estimates that 9.9 billion condoms were needed in 2002 for STI/HIV prevention in Africa, Asia, Latin America and Eastern Europe – a minimum figure, which assumes that condoms will not be used consistently and excludes those intended for family planning purposes.

It would have cost US$297 million to purchase those 9.9 billion condoms; more than $557 million will be required in 2015. These dollar figures are based on the average international price of US$0.03 per condom, which reflects a range of prices paid by various donors. However, they represent only the cost of the condoms (plus sampling and testing). They do not include any of the costs of distribution systems, communication for behavior change or other services required to get condoms into the hands of those who need them. This would increase the cost to at least US$1.5 billion for 2002 and at least US$2.8 billion for 2015.

Notes

  1. UNAIDS. 2001. AIDS Epidemic Update: December 2001. Geneva: UNAIDS .
  2. UNAIDS. 2000. Report on the Global HIV/AIDS Epidemic: June 2000.
  3. UNFPA. 2001. Donor Support for Contraceptives and Logistics: 2000. New York: UNFPA.