MAKING A CASE OF THE DILEMNA IN CONDOM USE

ARE UGANDANS SAFE?

Condoms are test tube-like sheaths made out of latex or polyurethane. Its use in Uganda must have started after the establishment of the Aids Control Programme in 1987 -to educate the public about how to avoid becoming infected with Human Immunodeficiency Virus (HIV) -under the clinical umbrella of; Abstinence, Being –faithful and Use of condoms (ABC).

Studies have confirmed that condoms are highly effective method of preventing HIV/AIDS –with effective rates ranging between 80% and 95% -depending on how they are effectively and consistently used. While female condoms, which give a woman more bargaining position, are at 98% (Population Action International, 2008).

According to World Health Organization (WHO) and the United States National Institute of Health, intact condoms are essentially impermeable to particles the size of Sexually Transmitted Diseases (STDs) pathogens –including the smallest Sexually Transmitted Virus (STV).

Much of the percentages for effective rates vary from one information source to another –all of which do not reach 100%. Yet one would be dealing with a life threatening disease. Greater confidence has shown on how condoms are manufactured, under strict quality control measures, which too stipulate that they are safe. But quality measurements are done basing on a merely on a particular sample of say, five or ten. What quality assurance, then, could one give to those outside the sample?

And with inaccessibility problem still at hand, where in Uganda, the gates to health bodies are now wide open to catch the virus. Mayuge District, with one of the greatest cases of teenage pregnancy, and probably, most fertile people, access is very remote. Yet the majority of Non Governmental Organizations (NGOs) are more in towns than rural areas. This puts health security at stake.

Firstly, in one independent survey carried out on HIV risk in Mayuge, young people, at least once, had unprotected sex. While at the same time, HIV testing facilities there are a dream. They could only be accessed at the main referral hospital. Now, how reliable could the prevalent rates be if in just one district the situation as that bad?
Secondly, absence of female condoms makes women entirely at risk of infection. If their male counter-part could find accessibility difficult, what would be the fate of women, who at all, lack key bargaining position; the female condoms?

Nevertheless, saying they (condoms) are effective, alone, is not enough because it would be a situation involving nature, fear and decision making to guarantee its usage. Not withstanding the fact that society has trained men to be brave, and women to be submissive, soft-hearted, and just to say yes to men’s advances. Given that background, how effective could condoms in particular and ABC strategy in general be?

Sex education too has not been adequate across post-primary and tertiary institutions. Well, an institution like Makerere University has Pastor Martin Ssempa –who has played a noble role in rallying students against HIV through abstinence slogan. As matter of fact, his works are already in the history of Uganda’s fight against HIV/AIDS.

But, firstly, are other schools and tertiary institution in similar motion against HIV/AIDS? Secondly, with the abstinence bit, as the value, does Ssempa’s team carry out annual survey to determine impact of his abstinence crusade?

Moreover, with the curiosity, that new students show, especially those joining universities from mainly strict homes and single schools; would be up to nothing, but to buzz into anyone that can treat the long awaited motive. Really, Ssempa’s abstinence gospel could be challenged. Yet, also, those arriving at universities; the land of the free could be like dogs that have just been let out.

Like, Ssempa, the Catholic Church is against condom use –preferring the mental condom. But with young people screaming hard to respond to their biological clocks, most obviously, could skip the church’s ditch, and manage “time” effectively. Moreover, for those who could be hit hard by the orthodox teaching, may suffer from secondary impotence. They could have got so much used to sexually restricted life, and then, feel most comfortable to do otherwise.

For domestic violence, child abuse, refugee camps, and conflict areas -where the risk of contracting HIV could be potentially high by virtue of the situation, and with condom use definitely un-negotiated, ABC and condom use in particular, would sound like here say to them. And neither Ssempa nor latex material would apply here.
Lack of knowledge about condom use could adversely count big for the young people. Even those, who have their access, might be using them without basic know how. They could, for example; be part of the cases that use same condom throughout the sex exercise, add unauthorized lubricants, use more than one or more condoms, fail to change at different stages of sex intercourse and unaware of when and under what circumstances he would change. What a mess!

Much of the effort, instead, must be on testing sexual partners that not only are about-to-marry, but also adolescents could be encouraged before joining sexual affairs. In about the same context, Uganda must face the reality that kids as early as 8 to 10 are at the stage of experimenting sexual feelings.

And thus; there is no reason, for sure, why condom distribution would be discouraged in primary schools. Are there records of no HIV transmission in the age bracket therein? It is something the country must take care of.

Meanwhile, sex education and life skills training could be started –where they are not, and strengthened, where they are. It would be with such a combination of training programmes that child or young adult would know how to deal with adolescent changes, pressures and/or inappropriate feelings as they emerge.

Truly, schools and tertiary institutions might need to change with changing times. How would it be if a child or student, who passed well at school went out and failed to approach life wholly? And, how would it feel if an ex-student ended up drowning into alcohol and drugs, fraud, drop out of school, join prostitution and, above all; catch HIV?

Jacob Waiswa
Situation Health Analysis
www.situationhealthanalysis.blogspot.com
waiswajacobo@yahoo.co.uk
+256774336277