It is hard enough to get a Malawian university student to tell you whether they use condoms or not, even worse to gauge whether they use them correctly and consistently. But in a country where poverty is believed to be the leading cause of HIV infections and early pregnancies, the issue of condom use is probably the last thing on people’s minds.
But recent research commissioned by UNFPA and the Ministry of Youth and Sports indicates it is not only poverty that is responsible for high HIV infections and fertility rates. Rather, it is the low condom use among Malawi youth. The research was conducted in 2011, but earlier in 2010, a UNAids Report mentioned low condom use as one of the factors that contributes to high HIV infections.
“Major factors in the transmission of HIV in Malawi are poverty, low literacy levels, high rates of casual and transactional unprotected sex, particularly among youth between the ages of 15 and 24 and low levels of male and female condom use,” reads the report in part.
Similarly, the 2010 Malawi Demographic Health Survey (DHS) says: “For young men, HIV prevalence is slightly higher for those who report not using a condom at their last sexual intercourse compared with young men who report using a condom,” reads DHS in part.
Based on these statistics and research findings, the Ministry of Youth and Sports will next month launch a Condomise Malawi Campaign to increase condom use among the youth and reduce unplanned pregnancies and HIV infections.
Deus Lupenga, principal youth officer in the Ministry of Youth, said the campaign will run with funding from UNFPA.
“The Ministry of Youth and Sports, in collaboration with UNFPA commissioned a study in 2011 to assess factors that contribute to low condom use among young people. The Condomise Campaign is aimed at increasing condom use among the youth and ultimately reducing unplanned pregnancies and HIV infection,” said Deus Lupenga during a media briefing on the campaign in Blantyre last week.
But why focus on the youth?
Malawi has a youthful population. According to the National Statistical Office, 73.8 percent of the country’s population is below the age of 30.
That is not all—the country holds the dubious distinction of having the highest rate of teenage births in the Sub-Saharan Region. Known as adolescent fertility, Malawi’s teen birth rate is 193 per 1000 girls, compared to countries such as Zimbabwe and South Africa which are at 101 per 1000 and 54 per 1000 girls, respectively. The teenage birth rate measures the number of live births to 15-19 year olds.
With such sobering figures, surely, Malawi’s high rates cannot be ignored.
Overcoming cultural barriers
The Condomise Campaign is advocating for increased condom use because the condom offers dual protection against sexually transmitted infections such as HIV, syphilis, gonorrhea and chlamydia, as well as unwanted pregnancies.
Early pregnancy rates are high partly due to cultural and religious values that encourage abstinence and promote condom-free #sex education among youths.
While describing condom use as “one of the most effective strategies for combating the spread of HIV”, the 2010 DHS admits the cultural challenges that stand in the way.
“Educating youth about condoms is sometimes controversial, with some people believing it promotes early sexual initiation,” reads the document.
And in justifying why the Condomise Campaign is focusing on tertiary institutions, principal HIV and Aids officer in the Department of Nutrition, HIV and Aids Khataza Chawanda said: “Policy does not allow for condom distribution in primary and secondary schools, only universities.”
Ironically, one of the reasons girls are dropping out of primary and secondary schools in Malawi is early pregnancies.
Thus, poverty and poor sex education combine to lead to risky sexual behaviour among the youth in Malawi. This is why, although the 2010 DHS says 79 percent of young women and 89 percent of young men know where they can obtain a condom, the youth are not always free to access and use them consistently and correctly.
According to Wilfred Lichapa, chief youth officer in the Ministry of Youth, the Condomise Malawi Campaign is targeting university students because they are easy to reach.
“Universities have been sidelined for a long time in as far as these programmes are concerned, yet university students are future decision makers and so they also need to be protected. Most districts have youth clubs and other avenues through which youths can access condoms, but university students do not usually have these facilities,” said Lichapa.
Chawanda said locally-branded condoms called Silver Touch, which are more appealing to the youth, will be distributed during the campaign.
“The condoms will be distributed to select university campuses and also in hot spots of six impact districts such as Blantyre, Lilongwe, Mangochi, Mzuzu and Karonga that the campaign is targeting,” she said.
Women and girls at risk
Although the country’s average HIV prevalence rate is at 10.6 percent, 12.9 percent of women are living with HIV compared to 8.1 percent of men, according to 2010 DHS. This means women and girls are more vulnerable to the Aids-causing virus than their male counterparts, yet this gender is the most disadvantaged when it comes to condom use.
Malawi introduced the female condom in 1997, with UNFPA scaling up promotions by making it available in hairdressing salons, but acceptance has been slow.
The 2010 DHS indicates that less than one percent of women use the female condom. Yet the one critical advantage of the female condom is that it is the only available technology for HIV prevention that women can initiate and control.
Random interviews conducted in the streets of Blantyre revealed that very few women have ever used a female condom, with many not knowing where to find them.
Acknowledging the gap in access to contraceptives, including condoms, among youths, Vice-President Khumbo Kachali said at the 2012 London Family Planning Summit that government would raise Malawi’s Contraceptive Prevalence Rate (CPR) to 60 percent by 2020 “with a focused increase on those aged 15 to 24 years.”
With increased condom use among the youth, government would be on track to meeting its goal of reducing unplanned pregnancies and STIs.
As the Condomise Malawi Campaign runs from September 16-30, government’s goal should be to ensure that the condoms are available to the youth even after the campaign is over, and more importantly, that they reach their target.