By The Society for Media Advocacy on Health, Nigeria,
The disease burden resulting from unsafe sex, including HIV infection and other Sexually Transmitted Infections (STIs), has profoundly impacted the health of people all over the world.
Looking at HIV prevalence rate for instance, since the beginning of the epidemic, 76 million people have been infected with the HIV virus and about 33 million people have died of HIV/AIDS and globally, 38.0 million people were living with HIV at the end of 2019, according to World Health Organisation (WHO).
The WHO African region remains most severely affected, with nearly one in every 25 adults living with HIV and accounting for more than two-thirds of the people living with HIV worldwide. In Nigeria for instance, UNAIDS and the National Agency for the Control of AIDS estimate that there are 1.9 million people living with HIV in Nigeria.
While STIs that go undiagnosed do not only lead to long-term complications such as infertility and cervical cancer but also enhance HIV susceptibility, consistent condom use remains the most effective barrier against STIs.
Condom is the only type of contraception that can both prevent pregnancy and protect one against STIs. There are two types of condoms: male condoms, worn by men; and female condoms, worn by women.
In recent time however, research has shown that the male condom has become more prominent than the female condom and the reason for that is not far-fetched.
A study titled: “Awareness and utilisation of female condoms among street youths in Ibadan, an urban setting in South-West Nigeria”, revealed that most Nigerians do not know how the female condom looks like.
The study which was conducted among 964 youths between ages 15 to 24 years old using questionnaires to elicit information, shows that almost half (47.9 per cent) of the respondents have heard about female condoms however only 16.8 per cent have ever seen one while 4.3 per cent have actually ever used a female condom.
Majority of Nigerians do not have the privilege to know how female condom looks like, simply because family planning service providers, who are the gatekeepers as they often have more time to spend with clients, mostly introduce the male condom to their clients.
One of sure clients is Mrs Abigail Uchenna who said each time she goes to a health facility to get condom, she is always been given the male condom. “I don’t even know how the female condom looks like,” she said.
While condom is the only type of contraception that can both prevent pregnancy and protect one against sexually transmitted infections, research has shown that the male condom cannot prevent infections like gonorrhoea alone.
According to a study titles: “Effectiveness of the female condom in preventing HIV and sexually transmitted infections: a systematic review and meta-analysis”, it was revealed that female condoms plus male condoms may be as effective as male condoms only in reducing HIV acquisition.
However, the use of female condoms plus male condoms is superior to male condoms alone in reducing the acquisition of gonorrhoea and chlamydia.
It says, “The use of female and male condoms is more effective than use of male condoms only in preventing chlamydia and gonorrhoea and probably more effective in preventing trichomoniasis and other STIs.”
Though female condom plays a key role in family planning, its use in Nigeria has remained very low due to culture, religion and other related barriers, says former country director, Pathfinder International, Dr Farouk Jega.
Jega listed some of the barriers to female condom as, “one in ten condoms imported into the country is for female, while the remaining nine are designed for men and the cost of purchase, access and low knowledge on availability of female condoms.”
He said, “If you look at the modern contraceptive methods generally, there is lack of awareness generally about the existence of modern contraception. But, even bigger problem I think is the disconnect between knowledge and use.
“Even though knowledge is about 74 percent of modern contraception among Nigerians, use is extremely low. Currently, only about 10 percent of people in Nigeria use modern contraception, that is as a result of very many reasons, cultural, religious, access issues.
“People may know about these contraceptives, but they do not know where to get them. They may not even have the wherewithal, that is the finances, to access them. Specifically, talking about female condom, for a long time, the problem has really been that of lack of awareness. We all know about male condoms for a long time, I think it is recently that the awareness about female condom is beginning to emerge.