peripheries

Mumbai’s NGO Campaigns to Normalise Condoms

As I was complaining that lateral thinking was dearly missing when it comes to condom promotion and sale, The National AIDS Control Organisation (NACO) and the Hindustan Latex Family Planning Promotion Trust (HLFPPT) installed two “camouflaged” vending machines in Mumbai as part of a ‘condom normalisation campaign’.

The originality of these Condom Vending Machines (CVM) is that they provide other general products like soaps and snacks too. “When we installed 3000 CVMs in Mumbai and Thane, we observed that people were still apprehensive about being noticed while operating the machine. So this is an attempt to camouflage the process of buying a condom by providing other things too,” said Rajesh Nainakwal, partnership manager for HLFPPT.

The closest picture available on the web comes from Japan and with a bit of imagination the real multi-convenience CVM could easily be pictured.

Interestingly the launch of the campaign coincides with the monsoon as it is believed that “commercial sex sees a spurt during rainy season”.

Let’s hope Mumbai’s men cover themselves before going out…

Protecting the Protection

Condoms sold in safety box at Tesco, London. (C) peripheries

A coalition of labor unions started a campaign to free condom from bondage in a major drug store chain in the US. The “Cure CVS: Unlock the Condoms Initiative” is concerned “that young people are less likely to ask a store associate for access to the condoms, exposing them to a greater chance of contracting HIV/AIDS or becoming pregnant if they don’t use such contraceptives.”

According to The Tennessean, a spokesman for the chain explained that the practice aims at preventing shoplifting in situation where it has reached such a degree that “the product is becoming unavailable for our customers to purchase, we take additional product protection measures.”

Interestingly it seems that not all stores enforce a condom protection policy, but that “in nine of 19 markets where the company locks up condoms, CVS was at least three times more likely to do so in communities of color than in majority white ZIP codes.”

Condom’s theft do happen all over the world. Such thefts could lead to extreme situations where the thief end up being arrested at gun point or face a lengthy jail sentence. Likewise, condom’s protection is not limited to the US (see picture).

What is most deplorable is that condoms being the best prevention method against HIV infection, people are resolved to steal them rather than buy them. It say a lot about how much more work is needed to de-stigmatize sex and if we can’t “decriminalise” sex (from a moral perspective) we won’t be able to do much when it comes to stigma surrounding HIV. It is even more discouraging when epidemiological evidences show that African American are more vulnerable to HIV infection.

Understandably, CVS is here to do business, not to run an HIV prevention programme, though with a bit of lateral thinking – dearly missed when it comes to HIV prevention, it could be possible to both make condoms more accessible whilst preventing them being stolen. Anyone who regularly get his morning coffee shot in a Costa or Starbucks will have noticed the robotic way with which shop assistants ask customers if they would like any cake with their coffee. What about CVS store employees doing the same?

“Any condom with this?“

HIV Prevention: Condoms work!

Despite an increase in intergenerational sex amongst female teenagers, despite an increase in the number of multiple partners amongst men age 15-24, despite a decrease in HIV prevention knowledge, the third South African National HIV survey conducted in 2008 showed a promising decline in the number of HIV infections amongst the 15-24 years old.

“HIV prevalence among adults aged 15-49 has declined between 2002 and 2008 in the Western Cape, Gauteng, Northern Cape and the Free State, with the largest decline of 7.9 percentage points in the Western Cape.”

This may well be explained by an increase in condom use:

“The proportion of the population who reported using a condom at their last sexual encounter was particularly high among young people aged 15-24 years: from 57% in 2002 to 87% in 2008 among young males, and from 46% to 73% among young females. This trend was also obvious in condom use among people in the 25-49 age group, where condom use among males aged 25-49 at last sex has nearly doubled, while among females in the same age group it has tripled.”

The survey conducted by by the Human Sciences Research Council (HSRC), in conjunction with the Medical Research Council (MRC) and the Centre for AIDS Development, Research and Evaluation (CADRE), sends a clear message:

Condoms work!

It also hints at a very different kind of HIV prevention intervention as suggested by another observation:

“The good news is that the change in HIV prevalence in children is most likely attributable to the successful implementation of several HIV-prevention interventions,” said Dr Olive Shisana, CEO of the Human Sciences Research Council (HSRC) and one of the two principal investigators of the study. “These interventions are related to addressing HIV in early childhood, particularly programmes to prevent mother-to-child transmission in the Western Cape, where the largest decline of 6 percentage points occurred.”

This is a completely different way of tackling the HIV epidemic with a dramatic shift from prevention to treatment and a focus on addressing sexual behaviours that most contribute to the spread of the epidemic such as multiple partnership and intergenerational sex.

The survey also confirmed that drug users and Men who have Sex with Men (MSM) are amongst those most vulnerable to HIV infection and that specific interventions are needed to reach these groups.

“For the first time, the report provides information on high-risk groups, defined in this study as people who drink excessively, those who take drugs, men who have sex with men and people with disabilities as well as women aged 20-34 and men aged 25-49. More attention should be paid to these categories in the NSP” said Shisana.

Evidences are piling up, action is urgently needed, starting by knowing your status (if the South African can do it and they did – “The percentage of people in the age group 15-49 who reported awareness of their HIV status has doubled from 2005 to 2008”, we can do it too) and by insuring human rights for those most vulnerable.

Reaching out to hidden MSM in Thailand

These animations have been produced by Mplus+ a grass roots community-based organisation formed to improve the sexual health of men that have sex with men (MSM), including transgenders, Thai male sex workers (MSW) and migrant male sex workers.

“These four animations aimed at increasing understandings of safe sex practices and addressing low perceptions of personal risk to HIV/AIDS. The project, an international collaboration, was undertaken because MSM and MSW were not adequately reached through HIV prevention programmes in Thailand because little was known about their particular situations, contexts and practices.”

HIV on the rise in the Philippines: Will condoms do any good?

Since the papal comment about condoms and the HIV epidemic, there has been a flurry of articles written in support of the pontifical nonsense. These often call upon a comparison between “sinful” Thailand, awash with HIV and condoms, and the “holly” Philippines where there is not such thing as HIV or condoms (a bit like in Iran).

Does this sound slightly over the top? Not really. Kathleen Gilbert writing for the LifesSiteNews website quotes Yolly Eileen Gamutam, head of the Asia’s Catholic Association of Doctors, Nurses and Health Professionals (ACIM-Asia) saying that “Condoms are highly dangerous.” Gilbert added that “by the end of 2003, Thailand, with a population of 63 million, registered 570,000 HIV-positive adults and children. Gamutam compared the statistic to the Philippines, where only 9,000 Filipinos were HIV-positive out of a population of 80 million. 500 died of AIDS in the Philippines that year, while 58,000 perished in Thailand.”

peripheries has already addressed this misleading and inappropriate comparison but it is necessary to add that comparing two countries at one time point is rather meaningless. That the head of an association of doctors allows herself to be so unscientific is rather disappointing, if not telling that religion and science are definitively two nonoverlapping magisteria.

But let’s look at the figures available from UNAIDS and let’s compare the number of People Living with HIV and AIDS (PLWHA) at two time points:

In 2001 there was 660,000 adults and children living with HIV and AIDS and this figure dropped to 610,000 in 2007. In the Philippines, the number of PLWHA rose from less than 1,000 to 8300 and has been continuously on the rise since 2006.

Without fear or shame and against all evidences, Yolly Eileen Gamutam concluded that “the condom use program in Thailand is not effective.” Mechai Viravaidya, politician and leading Thai AIDS activist who introduced a 100% condoms policy in brothel where HIV was raging and henceforth contributed to a reduction of the number of PLWHA from 2% to 1.4% in 10 years (1997-2007) and the successful containment of the epidemic, will appreciate how his work and continuous efforts are being so promptly dismissed.

The rise in the number of HIV infections in the Philippines may not seem dramatic now but it may have some serious consequences later if not controlled. Conscious of the consequences of inaction, the Filipino government, who in the past adopted an approach to the epidemic that limited its progression in the general population, was considering a controversial bill on reproductive health at the end of 2008.

Another worrying concern about the rising HIV epidemic in the Philippines is that it is so far mostly observed amongst Men who have Sex with Men. The health departmental HIV/AIDS registry recorded 210 new infections among MSM in 2005, 309 in 2006 and 342 in 2007 and from January to September 2008, there were already 395 cases, up 96 percent since 2005.

And as we all know, before or next to condom, homosexuality is the next “abomination” that the Catholic church condemns with wrathful vehemence.

“The Catholic Church’s centuries-old doctrine, created by a bunch of celibate priests, on sex only for procreation leaves many people ignorant about sexual health. This is the sad reality.

Taking away people’s right to protect themselves, and their right to education and to responsibly manage their sex lives is certainly taking away some of their humanity.” write William Sparrow for the Asia Times.

But not all Catholics are dogmatic or blinded by credo and for example, Catholics for Choice an organisation initially founded to support women’s moral and legal right in a world led by Bishops, started an unprecedented worldwide public education effort to raise public awareness about the devastating effect of the bishops’ ban on condoms. In a recent press release the organisation wrote:

“According to a recent poll commissioned by Catholics for Choice, which interviewed Catholics in Ghana, Ireland, Mexico, the Philippines and the United States, support for condom use among Catholics is overwhelming. When asked if “using condoms is pro-life because it helps save lives by preventing the spread of AIDS,” 90% of Catholics in Mexico, 86% in Ireland, 79% in the US, 77% in the Philippines and 59% in Ghana agreed. Unfortunately, the Catholic hierarchy’s position holds the most sway in the countries least able to deal economically and medically with the disease.”

A sway leading to death. And as for the role of condoms, they certainly won’t do any harm.