Counting Condoms: How Many Are Needed for HIV Prevention Efforts?

Estimates of the number of condoms needed are complicated by the lack of data on condom use for HIV/STI prevention. Estimates of need are most often based on data on the number of condoms supplied. One rough estimate of the numbers of condoms actually used worldwide spans a range of six to nine billion condoms annually (1999 data), which translates into exceedingly low levels of use, given what survey data reveal about the frequency of sexual intercourse among married and unmarried men.

An accurate estimate of need is difficult to calculate. The number of condoms required depends not only on the nature of other prevention activities being implemented, but also on the assumptions used and countries included in the calculations. Indeed, there are various estimates of need, but each one uses different assumptions, methodologies, and is for a different set of countries.

Whatever the precise number of condoms needed, however, the fact is that current use is too low to have an impact on the rate of increase of infection. Condom availability and access must be greatly expanded everywhere.

UNFPA estimates that 8 billion condoms were needed in 2000 for STI/HIV prevention in Africa, Asia, Latin America and Eastern Europe, but the actual need is greater. UNFPA’s is among the few estimates of need that cover all countries except for the wealthy donor countries of Northern America, Europe, East Asia and Oceania. It is regarded as a minimum figure because it excludes condoms intended for family planning purposes (most of which are used by married couples), and assumes that condoms will not be used consistently.

Most of the condoms are needed in Asia (excluding Central Asia), due to the large population size (4.5 billion condoms in 2000), according to UNFPA’s estimate. Latin American follows with an estimated need for 1.2 billion condoms, while another 1.2 billion were needed in the Middle East, Central Asia and Eastern Europe combined. The need for sub-Saharan Africa stood at 1.1 billion condoms. By 2015, at least 18.6 billion condoms will be needed, according to UNFPA, distributed across regions in the same proportions as in 2000.

It would have cost US$239 million to purchase the minimum 8 billion condoms needed in 2000, based on the average international price of US$.03 (3 cents) per condom, and more than $557 million will be required in 2015. These dollar figures, however, represent only the costs of the condoms themselves (plus sampling and testing). They do not include any of the costs of distribution systems, communication for behavior change, or the other services required to get condoms into the hands of those who need them, which would have increased the cost to at least $1.2 billion for 2000 and likely higher. For 2015, total costs would be at least $2.8 billion.

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