Abstract
Correct and consistent condom usage remains a pivotal strategy in reaching the target set by the South African government to reduce new HIV infections by 50% in the next 5 years. Studies have found that there has been an increase in condom usage by some categories of the population, but usage has not yet reached the desired levels in order to meet the target. This article reports on the findings of a study on condom usage in eight communities in the North West Province, which was part of a wider HIV and AIDS programme evaluation commissioned by the North West Provincial Department of Health. The main aim was to assess accessibility to condoms, and knowledge, attitudes and practices around condom use by four sampled communities in the North West Province. Eight focus group discussions were held and 50 households were interviewed. The study found positive results regarding accessibility and awareness of condoms. However, this often did not lead to the desired behavioural change of using condoms in risky sexual interactions. The majority of respondents still resisted condom usage, used condoms inconsistently, or were not in a position to negotiate protected sexual intercourse. The main reasons reported for this were: reduced pleasure, perceived and real physical side-effects, myths, lack of information, status, financial reasons, distrust in the efficacy of condoms, family planning, cultural reasons, gender-related reasons and trust. Many of the barriers to consistent condom use cannot be overcome by strategies that target the individual. Interventions need to address underlying developmental factors such as the non-biological factors that increase the susceptibility of women to HIV infection. As this falls outside of the scope of the mandate of the Department of Health, various partnerships with other key role players need to be established and/or strengthened, such as with local government, non-governmental organisations and faith-based organisations.
Highlights
One of the primary aims of the new National HIV and AIDS and sexually transmitted infections (STIs) Strategic Plan for South Africa 2007 - 2011 (NSP) (2007) is to reduce the rate of new HIV infections in South Africa by 50% by 2011
A successful strategy aimed at condom supply and use consists of: getting condoms to the people; getting people to the condoms; and getting people to use condoms correctly as well as consistently (Hearst & Chen, 2004; UNAIDS/UNFPA, 2004)
The most recent national HIV and syphilis antenatal seroprevalence survey (National Department of Health, 2003) at the time of the study estimated that 5.6 million South Africans were HIV positive by the end of 2003, 3.1 million of whom were women, 2.4 million were men and 96 228 were babies
Summary
One of the primary aims of the new National HIV and AIDS and STI Strategic Plan for South Africa 2007 - 2011 (NSP) (2007) is to reduce the rate of new HIV infections in South Africa by 50% by 2011. While the South African national HIV prevalence, national incidence, behaviour and communication survey by Shisana et al (2005) revealed that condom usage had increased in the 15 - 24 age group to 72.8% for males and 55.7% for females, compared with the similar household survey in 2002 (Shisana & Simbayi), this was not the case for the other age groups. Of respondents with more than one current partner, 60% indicated having used a condom at the last sexual intercourse. This means for those who did not use a condom, a large group of the population is at a high risk of HIV infection
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