Closing the Condom Gap
Consistent condom use by nonmonogamous sex partners could protect millions of people from HIV infection and other sexually transmitted diseases (STDs) and reduce the enormous costs associated with STDs. Condom use needs to increase to about 15 billion/year (from 8-10 billion/year) to prevent STDs. An estimated 33 million people live with HIV/AIDS worldwide, and an estimated 16,000 people are infected with the virus each day. In 12 out of 15 countries surveyed, more than 75% of never-married men have changed their sex behavior in response to HIV/AIDS. While condom use remains low within marriages (approximately 7%), some married couples use condoms in combination with another contraceptive. Recent surveys of sexually active, unmarried people have found rates of condom use of 2-17% among African women, 7-50% among African men, <1-36% among Latin American women, and 27-64% among Latin American men. Many unmarried, sexually active people continue to practice risky sex behavior--even when they know about STDs and condoms--because of mistaken beliefs that they are not at risk and/or because social norms discourage condom use and encourage high-risk male sex behavior. Traditional gender roles and fear of violent reactions inhibit women from talking about sex with their partners or negotiating condom use. Promotion, advocacy, communication campaigns, and counseling can change social norms and inform people about risks. Governments must help close the condom gap by adopting policies that make condoms widely available and universally accepted. Donors must also provide adequate funds and technical assistance to meet this challenge.