The Condom Saga: Why do Indians still shy away from using protection

Mangalore Today News Network

Feb 17, 2016: The innocuous piece of rubber that was to draft the history of many national programmes and change the way relationships were viewed came into the country in a big way with the National Family Planning Programme in 1951. In spite of the government’s best efforts to make family planning attractive to young married people, the programme failed in a big way. The male-dominated society wasn’t going to accept a rubber between its ego and the freedom to procreate and have sex. Family planning was and still is considered the female’s responsibility.

 

In the late 1980s and early 1990s as HIV started becoming a familiar name in the corridors of the health ministry, a renewed focus was directed towards the forgotten condom. Efforts were made to popularise it as the best means of dual protection. Limit your family and remain STI/HIV-free by using condoms was the new mantra. It worked for some time and there was an increased uptake among vulnerable populations.

Unprotected sex was considered taboo and free condoms were distributed far and wide through every means, including social marketing, vending machines, kiosks, village depot holders, unorthodox distribution points, etc. Everything looked good, family size seemed to have limited itself to around two kids in most states and new HIV infection rates were coming down fairly steeply to allow the government to thump its chest and claim successful prevention strategies. However, if one scratched a little deeper, not everything seemed pink and rosy. There were several reports that condom stockouts were limiting good prevention attempts.

The National AIDS Control Organisation (NACO) led targeted interventions for vulnerable populations were screaming themselves hoarse demanding immediate supplies of condoms. Supplies had run dry and no solutions were available. Government data released in November 2015 showed that less than two-thirds of the 31 states in the country had more than a month’s supply of condoms. Some had stocks for only a few days. Matters came to a crescendo when the Delhi Commission for Women (DCW) chief Swati Maliwal sought a detailed report from NACO on the shortage of condoms. The National AIDS Control Programme has been grappling with condom shortages in the past couple of years. The exact reasons for shortage are unknown as the governments standard reply has always been "we are looking into it and the shortages will be covered soon". Protests, parliamentary questions and media reports made little difference to the status of stockouts for more than 10 months.

Possible reasons could be budget cuts and a delayed procurement tender that was recalled due to technical discrepancies. Several states have been severely affected by the shortages. To top it, the condom still remains a choice for the male, limiting the negotiating powers of the women. Female condoms have never been promoted by the government in a big way. A few donor-funded pilots showed some successes, but these were not scalable. Access and availability were a problem and with severe shortages of the male condom, vulnerable populations like female sex workers were either forced to invest in the more expensive commercial condoms or have unprotected sex.

Other infections like Hepatitis B, Hepatitis C and HPV are also sexually transmitted and causing high morbidity and mortality. Condoms, therefore, are the cheapest and most efficient means of preventing transmission of these diseases. In the recent years, emerging epidemics including HIV have been shown to be fuelled by migrants in many low prevalent states like Odisha, Jharkhand, UP. A greater access to condoms should be the strategy to all populations — vulnerable or otherwise — as the right to good health and access to protection is equal and unequivocal.

A few political leaders feel that promoting condoms on national channels and during prime time may decay the fabric of social culture and lead to loose moral norms. Airtime has therefore been restricted to late or “adult” hours limiting access to young people seeking information

International Condom Day on the 13th of February is celebrated to renew the focus on condoms and draw the attention of governments to this cheap and successful strategy to protect vulnerable populations. It was initiated by Aids Healthcare Foundation and is now commemorated with several activities across 31 countries of the world. In India, it is celebrated by India Cares, AHF’s institution in India. The theme for this year is “Wrap your Love".