Unsung heroes in the HIV/AIDS battle

Mbongeni Mguni | Friday June 27, 2014 16:55

 

Recently, local stakeholders involved in the fight against HIV/AIDS punched the air in joy as figures from a 2013 study showed remarkably positive promise in the 28 year-old battle against the disease.

 

The uptake of the Prevention of Mother to Child Transmission (PMTCT) programme was peaking at 96 percent while that of Antiretroviral (ARV) therapy had risen to 87 percent.

 

Together with higher testing levels, more male circumcision and better understanding of the risks within the population, these interventions helped HIV incidence or the number of new infections to drop to 1.35 percent in 2013 from 1.45 in 2008.

 

A key statistic many focussed on was the level of HIV prevalence, which rose to 18.5 percent last year from 17.6 in 2008, showing that more people were living and surviving with the disease, than dying from it.

 

Within these figures, the role of the condom has taken been relegated to that of a mascot on the touchline, watching other more illustrious actors on the field of battle.

 

However, this was not always the case.

 

On that tragic day in Selebi Phikwe in 1985 when the first AIDS case was diagnosed in Botswana, condoms were chief among the arsenal that government and its civic partners would later develop to fight the epidemic.

 

The free distribution of condoms and programmes to encourage their use, were quickly taken up by government and its civic partners as one of the key prongs in the fight against the scourge.

 

While today, the novelty of the condom has declined in line with its greater uptake and usage, newer programmes such as PMTCT, ARVs and “new kid on the block” Safe Male Circumcision are grabbing the headlines.

 

However, statistics released by world leading social marketer of condoms, PSI International, indicate that the first soldier in the vanguard against HIV/AIDS is still out in the field in numbers.

 

A PSI International study conducted between November 2012 and November 2013 found that 30.4 million condoms were sold or distributed in Botswana in 2012 up from 19.4 million five years before that. At that level, the number of condoms sold in 2012 was more than 15 times the country’s population.

 

The figures are also reflected in PSI Botswana data for May 2014 showing a total distribution of 204, 720 condoms.

 

As usage levels have risen, the market’s value has also grown to P67.6 million or twice that of 2007, with the value driven by the entry of higher-end products and price adjustments in the popular PSI brands of Lovers Plus and Trust.

 

By 2013, the local market had 13 condom brands, with the most popular being Moods, which lowered its prices in late 2012 and thus cornered the market. However, other higher-end brands such as Durex and Contempo also carved out their niches and had a five percent share of the market in 2012.

 

PSI’s own Lovers Plus and Trust have also maintained their share of the market and accounted for ten percent of the market in 2012.

 

Government issue condoms, however, dominate and innovation around the demand has over the years seen introduction of increasingly colourful brands, being a far cry from the early days of the “no-name” products.

 

Today, Lorato, Carex and Sekwata enjoy an 85 percent market share and are accessible to “users in hard-to-reach and informal locations such as shebeens, cattle posts, and high density multiresidential homes”.

 

Higher sales and distribution figures have also coincided with higher usage as noted by the PSI study showing that in 2010, 87.6 percent of men and women reported using a condom with a non-cohabiting, non-marital partner in their last sexual encounter, up from 81.2 percent in 2007.

 

The role of the lowly condom in prolonging life and preventing new HIV infections is not lost upon PSI Botswana.

 

“Although large-scale HIV prevention efforts have resulted in a decrease in new infections over the past two decades, consistent condom use remains critical for preventing new infections,” the organisation says in its study.

“Male condoms are a vital part of Botswana’s National Strategic Framework for HIV prevention, and because condoms offer dual protection against HIV and unplanned pregnancy, they also play an important role in family planning.”

 

In fact, the organisation notes that in Botswana, the number of condoms needed to protect all sexual acts from HIV infection and unplanned pregnancy is higher than the actual number of condoms on the market.

 

“However, public health efforts to improve access to condoms have succeeded in growing the condom market and condom use among both males and females, including those with higher risk behaviour,” researchers note.

 

The condom’s lowly positioning in the HIV/AIDS narrative, seems confirmed by PSI Botswana’s findings that mention “a lack of consistent promotion and education for condoms”.

 

“Condoms are a cornerstone of HIV prevention and it is important that adequate funds are allocated for long-term promotion of free condom brands,” the organisation notes.

“Although behaviour change communication campaigns have been implemented in the past, they are not often sustained. This can weaken brand perception and contribute to inconsistent condom use.”

 

With the efforts of PSI International and government’s ongoing support, the original soldier in the vanguard against HIV/AIDS may once again receive a share of the limelight in the brightening narrative around the epidemic.