The key role of condoms in the life-cycle approach to HIV
International Condom Day is marked on 13 February each year. On this occasion, our subsidiary Ulinzi Latex takes a look at a recent UNAIDS report, which describes how people are vulnerable to HIV infection at various points throughout their lives. From this perspective, UNAIDS advocates a ‘life-cycle approach to HIV’, which can be leveraged to better meet the distinctive needs of people depending on the stage of their life. Condoms play a key role in this approach.
Adolescence – a very dangerous time when condoms can help
Statistics show that young people globally, between the ages of 15 and 24, are at high risk from HIV infection. In particular, young women are at particular risk, with more than 7,500 each week becoming infected. This is a significant problem in eastern and southern African countries. As the graph below indicates, the HIV infection rates amongst young women globally have remained relatively flat, with only a gentle decline. If the published targets of reducing HIV infections amongst young women to 100,000 per year by 2020 are to be met, then a much more drastic decline is required over the next four years. This challenge is magnified, as over the past 10 years there has been a threefold increase in children living with HIV, who then grow into adolescence. This makes the life-cycle approach more necessary than ever.
A range of solutions to combat HIV infections amongst adolescents are needed. Availability of either free or heavily subsidised condoms plays a critical role in HIV prevention amongst this population segment. However, they cannot be used in isolation and other complementary measures are required from behavioural change communication programmes and HIV testing services through to campaigns to increase attendance of girls at school and to prevent gender based violence.
Family planning also of critical importance for 15-24 year olds
In addition to HIV prevention, condom availability is central to family planning campaigns being undertaken in various regions. According to the UNAID Demographic and Health Surveys (DHS) Program, family planning in Africa is being delivered reasonably well amongst 15-24 year old girls in some countries, such as Namibia, Kenya and Zimbabwe. However, their surveys indicate that , in others, such as Mozambique, Uganda and Nigeria, in excess of 50% of demand is not met.
HIV infection rates in the most vulnerable populations of high concern
The most vulnerable populations are defined as people who inject drugs, sex workers, transgender people and men who have sex with men. In 2014, 45% of new HIV infections around the world occurred among members of these communities, and HIV infection rates are on the rise, as shown in the graph below:
There are many hurdles involved in HIV prevention efforts within these communities. Whilst there might be widespread understanding of the risks of unprotected sex, various issues are combining to hamper the ability to provide community-based HIV prevention services. Such issues include social, legal, political and human rights challenges, as well as ongoing harassment and prejudice. So whilst condoms in this case still have the potential to protect people and reduce infection rates, there is often much work to be done to provide the right environment in which this can actually happen. So in addition to condom distribution, policy and structural changes need to take place such as political and legal change, community outreach and empowerment, and the reduction of stigma and discrimination. Realistically such culture change may take many years to achieve.
The life-cycle approach should be leveraged as much as possible in order to address one of the greatest challenges facing the global AIDS response: the stalled progress on HIV prevention among adults. After the age of 25, HIV infection rates are at the highest levels compared with other age groups, with 50% of new infections occurring within men aged between 30 and 49 globally. It is also worrying that these high infection rates are not showing any signs of decline. An area of particular concern currently is western and central Africa, where it has been shown that notions of masculinity inhibit men from accessing health services or using condoms.
UNAIDS advocates for a wide variety of programmes to tackle HIV infection rates. In addition to the availability of condoms which is a vital preventative tool, policies and education around alcoholism and spousal separation, sex education, gender norms and masculinity campaigns, and HIV testing and antiretroviral services are all required.
Holistic approach is key to success
In order to meet the ambitious objective listed as part of the Sustainable Development Goals to eradicate HIV/AIDS by 2030, investments must be made in a wide variety of inter-connected programmes throughout the HIV life cycle. By adopting this holistic approach, within which the distribution and availability of condoms is a critical part, we can work steadily toward a future that is free from HIV.
About Ulinzi Latex
Ulinzi Latex, part of NRS International, is a newly established company that will manufacture and supply high quality, totally reliable and affordable reproductive health products for the institutional market. By 2022, we aim to become the largest condom manufacturer worldwide by volume.
Building our ambitious project on a greenfield site in Lahore, we plan to build up our production capacity gradually. By 2022, we aim to manufacture more than eight billion condoms each year. This will give greater access to family planning and will bring new impetus in the fight against HIV/AIDS. By working with all stakeholders, we can together make a significant and long-lasting contribution to many of the Sustainable Development Goals, and so make the world a better place for all.