Sexual and reproductive health services, including family planning, are among the most important elements of the global effort to contain the HIV/AIDS pandemic. Through a well-established infrastructure, they help provide the supplies, education and information that are known to be effective in preventing the spread of infection.
How is prevention important to the fight against HIV/AIDS?
In the absence of a vaccine, preventive measures remain extremely effective and affordable interventions for slowing the pandemic. A successful HIV prevention strategy includes education about transmission, promotion of the benefits of delayed sexual debut, encouragement of having fewer partners, provision of skills to negotiate safer or no sex and promotion of consistent and correct condom use. It also makes HIV/AIDS testing available to those who want it, aims to prevent mother-to-child transmission and seeks to treat infected individuals.
Successful prevention efforts involve strong political will to confront the disease and active participation by various sectors of society. In Uganda, programs encourage safer sex behaviors through condom promotion and distribution, radio and TV advertising and peer education. These programs emphasize outreach at the local level and engage all sectors of government and society, including religious leaders and community groups. Uganda now has a high level of HIV/AIDS awareness and an increased demand for counseling, testing and condoms. It also has seen a reduction in HIV infections among young pregnant women and adolescent girls.
Why is the need for condoms growing?
Preventing the spread of HIV/AIDS and other sexually transmitted infections (STIs) requires a concerted effort to provide sufficient supplies of condoms. Current condom supplies already fall well below the need in some countries. The increase in need is fueled not only by increasing HIV prevalence, but also by growing interest in contraceptive use and by the large number of people entering their reproductive years. The United Nations Population Fund (UNFPA) estimates that 18.6 billion condoms will be needed for STI/HIV prevention in the developing world in 2015 at a cost of US$557 million, excluding substantial delivery and distribution costs.
|Condoms Needed for STI/HIV Prevention, 2000-2015These figures include condoms needed for protection from STI and HIV infection only, and exclude those needed for family planning.
Source: UNFPA (personal communication), 2001.
How do economic constraints and gender inequities contribute to the spread of HIV/AIDS?
Poverty makes it difficult to learn about HIV/AIDS or to purchase condoms or drugs.Additionally, leaving home to seek employment may lead to a separation from family and community, which in turn may lead to the establishment of other sexual relationships or reliance on commercial sex workers.
Social and biological factors cause a disproportionate number of new HIV infections among women, especially in sub-Saharan Africa. In manyparts of the world, women’s low social status and lack of access to economic resources put them at increased risk of HIV infection. At the same time, high rates of STIs, especially those causing genital ulcers, increase women’s susceptibility to the virus.
Societies need to address poverty and the roots of gender inequities, including the unequal access of girls and women to resources, formal education, economic opportunities and legal support.
Adequate resources need to be allocated for the development and promotion of new technologies, such as microbicides. Female condoms also offer women an additional means of protecting themselves, but remain largely unaffordable, if at all available.
What is the role of young people in the AIDS pandemic?
Worldwide, 12 million young people aged 15 to 24 have HIV or AIDS. Every year, almost half of all new HIV infections and at least one-third of all new STIs occur among people aged 25 or younger. Young people tend to consider themselves invulnerable to risk, and the unplanned and sometimes secretive nature of their sexual encounters makes protecting themselves difficult. Yet the social vulnerability and immature reproductive tracts of young people, especially girls, make them more susceptible than adults to acquiring STIs.
Young people tend to lack access to the information and services they need to protect themselves from STIs. Surveys in Mozambique found that three-quarters of girls and close to two-thirds of boys aged 15 to 19 did not know how to protect themselves from HIV infection. Prevention programs should make a concerted effort to reach young people, both in and out of school.
What is happening to donor support?
Donor funding for condoms is fluctuating. After falling trends in donor funding for all reproductive health supplies in the 1990s, donor funding for condoms peaked at US$91 million in 2001—double the amount spent in 2000 due to one-time contributions from a few European donors to UNFPA, but only one-third of the total estimated need.
Strategies must focus on increasing and maintaining funding for condoms. It is essential that donors, developing country governments and the private sector implement plans to ensure the availability and affordability of supplies. Coordinated and collective action at the global and national levels is required to build commitment, strengthen national capacity, secure consistent financing and improve efficiency in order to respond adequately to the HIV/AIDS pandemic.
- UNAIDS. 2001. AIDS Epidemic Update: December 2001. Geneva: UNAIDS .
- UNAIDS. 2000. Report on the Global HIV/AIDS Epidemic: June 2000. Geneva: UNAIDS.
- UNFPA. 2001. Donor Support for Contraceptives and Logistics: 2000. New York: UNFPA.