Condom promotion campaigns in sub-Saharan Africa have been successful
There has been a substantial rise in the use of condoms reported by young, sexually active, single women in sub-Saharan Africa, according to an Article in this week's issue of The Lancet. The study found that most women who reported using a condom stated pregnancy avoidance as their reason. The authors therefore suggest that condoms may be promoted more effectively if the emphasis was on pregnancy prevention rather than prevention of sexually transmitted disease.
John Cleland (London School of Hygiene and Tropical Medicine, UK) and Mohamed Ali (WHO) assessed trends in sexual abstinence, contraception, and condom use by single women aged 15-24 years in 18 African countries. They used data from comparable surveys involving 132 800 women in total. The researchers found that between 1993 and 2001, the proportion of women declaring themselves virgins rose significantly in seven of the 18 countries and fell significantly in six. On average, abstinence over the 3 months preceding the survey increased from 43.8% to 49.2% in the 18 countries. For women who reported having sex in the 3 months preceding the survey, use of any contraceptive method rose slightly from an average of 32.6% to 36.5%. Use of non-barrier methods (mainly contraceptive pills) changed little, whereas use of periodic abstinence fell slightly. Use of condoms rose substantially during the study period, from an average of 5.3% to 18.8%. This rise was significant in 13 of the 18 countries. In the most recent surveys from these 13 countries, 60% of the women said they were using condoms for pregnancy prevention.
Professor Cleland concludes: "The finding that condoms have now become the dominant method of contraception is to be welcomed because of their dual protection against HIV transmission and pregnancy…A young woman might find it easier to negotiate use of condoms with a partner for prevention of pregnancy than for protection against HIV transmission. Therefore, we suggest that condoms might be promoted more effectively if the emphasis was on pregnancy prevention rather than prevention of sexually transmitted disease."
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See also accompanying Comment.
Contact: Dr Mohamed M Ali, Department of Reproductive Health and Research, World Health Organization, 1211 Geneva 27, Switzerland. T) 41 22 7911489 firstname.lastname@example.org
John Cleland, Safari Park Hotel, Nairobi available in the evenings Nairobi time via the switchboard T) +254 20 3633000, +254 20 8562222
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