CONDOMS: Familiarity breeds contempt of use


CONDOMS: Familiarity breeds contempt of use

This year’s theme is Always in Fashion and has been localised to state Condoms. Forever Fashionable.

While condoms are an effective means of contraception and disease prevention, experts are worried by the lack  of consistency in their use, which reduces as a relationship gains history and becomes more exclusive and committed.

In most relationships, the condom is phased out or used as a transition to graduate into another birth-control method — or, in other cases, no method at all.

Dr Vernon Mochache from the National Aids Control Council (NACC) terms this as condom fatigue, when one gets so used to it and one’s partner that one sees no need to protect oneself.

“Over time, people in relationships look at the person they are dating and think they are less risky because of the trust they have built over the days,” says Dr Mochache.

Tied to this fatigue is the touchy issue of condom biases, including the belief that they reduce sensitivity, have a funny smell,  and cause allergies.

Philanthropist Bill Gates seeks to address this “inconvenience” in an ambitious move to come up with “The Next Generation Condom”.

In marriages, the concern is not fatigue, but that the insistence to use a condom shows lack of trust in a partner, according to the 2014 National Survey on Male Involvement in Family Planning and Reproductive Health in Kenya.

“There is no way I will tell my husband to use a condom with me,” says Milka Kerubo, a mother of five who lives in Nairobi. “He will want to know why.”

The International Condom Day, marked yesterday, February 13 — conveniently a day before Valentine’s Day — seeks to debunk these myths and encourage condom use. Championed by the Aids Health Care Foundation, the day is aimed at promoting safer sex in an attempt to cut the risk of HIV infection.

'FOREVER FASHIONABLE'

This year’s theme is Always in Fashion and has been localised to state Condoms. Forever Fashionable.

But two in 10 sexually active Kenyans who use these devices do not do so correctly throughout the duration of sex, yet any breach of use presents an opportunity for acquiring or transmitting HIV, other STIs, and unanticipated pregnancies.

A 2016 study titled Estimating the Prevalence and Predictors of Incorrect Condom Use among Sexually Active Adults in Kenya showed that the common errors and problems during use are not using condoms throughout intercourse (late application, early removal), breakage, slippage, and leakage. Nearly two in ten in the study reported at least one instance of incorrect condom use.

Individuals who reported condom breakage or slippage attributed it to mishandling before use (wrong storage, tearing during wearing) or using the sheaths under the influence of alcohol or other drugs, which impaired them.

This fuels the high rate of STIs such as HIV in sub-Saharan African communities, with most new HIV/Aids infection cases in Kenya occuring among young adults and adolescents.

The 2016 Kenya Aids Progress Report shows that young people aged 15 to 24 account for 51 per cent of total new infections, a 30 per cent rise from 2013.

NACC head of communication, John Ohaga, says they have adopted the maxim that “prevention is the best cure against HIV”, and that use of condoms “is one such intervention”.

Intergenerational sex, especially among young girls who have sex with (rich) older men — also known as sponsors — usually means that the girls are unlikely to negotiate the use of condoms due to the power and economic dynamics at play.

Cultural standards also stand in the way as condom use in marriage is seen as a sign of promiscuity, as highlighted in the 2014 National Survey on Male Involvement in Family Planning and Reproductive Health in Kenya.

Low condom uptake, incorrect and inconsistent use, and biases around the devices have led health researchers to argue that the fundamental characteristic of all HIV prevention strategies is that, to reduce risk, individuals are asked to “give up behaviour that is enjoyable, gratifying, highly reinforced, and often long-standing, and replace it with alternative patterns that are almost certainly less gratifying, more awkward or inconvenient, and more difficult to enact than present behaviour.’’

Philanthropist Bill Gates seeks to address this “inconvenience” in an ambitious move to come up with “The Next Generation Condom”.