A study conducted by the CDC states that “Latex condoms, when used consistently and correctly, are highly effective in preventing the transmission of HIV.” For centuries male condoms have been in use to prevent pregnancy and sexually transmitted diseases (STDs). Although, there are different types of condoms, such as those made from latex, polyurethane and lamb intestine, the most widely used in Ethiopia is the male latex condom.
Estifanos Teshome, a healthy-looking vivacious character living with HIV, told us that when he first started to have sexual intercourse at the age of 11, not much was known about condoms or HIV/AIDS. He said someone who wanted to buy condoms, found in pharmacies at the time, was considered as a promiscuous person. Not only that “At that time, if a woman asked a man to use a condom, the man will think that it’s because she has an STI or HIV. No one would trust her or would want to have any relations with her. In those days, the general opinion was that condoms were for promiscuous persons and those who had STIs.”
He argues that even today, this perception has not changed much. “I work in a health center in the area of HIV/AIDS, I see people look at those who come to take condoms suspiciously as though they were doing something wrong, as if they were promiscuous. It’s still frowned upon.”
The 2005 DHS shows that the level of knowledge for prevention methods of HIV/AIDS such as abstinence and faithfulness is relatively high as compared to knowledge of condoms and its role in the prevention of HIV transmission. It states that only “around four in ten women and six in ten men are aware that using a condom during sexual encounters can reduce HIV/AIDS transmission” (DHS,2005).
Estifanos told us that although he knew about the benefits of condoms, he did not like to use it because he thought putting it on was too troublesome and did not like its smell and oiliness. “Even today, if I were to dress well and had money to spend, I can convince ladies to go out with me. I can easily persuade them to have sex without a condom, you see, nowadays women’s focus is not so much on negotiating for safer sex, they just want to be with someone with money,” said Estifanos.
Interestingly, however, based on the 2008 Health Impact Evaluation, although one may think that young women in the lowest wealth quintile would engage in risky sexual behavior, young women with secondary and above education and those in the highest wealth quintile engage in risky sexual behavior more than those in the lowest. This is despite the fact that the level of comprehensive knowledge about HIV increases with education and wealth status (2008 Health Impact Evaluation).
On the other hand, Kelemu Belete, a 20 year-old boy who debuted sexual intercourse at the age of 15, told us that although he has never had sex without a condom, he has a female friend who has had sex without a condom with a partner who told her that because he looks healthy, she should trust him to have unprotected sex.
“Even though she had the awareness about condoms and HIV, she was forced to have unprotected sex maybe because she felt too embarrassed to persuade him to use one,” Kelemu said.
The 2008 Health Impact Evaluation shows that only 53.2% of women know that it is possible for a healthy-looking person to have the HIV virus.
In a patriarchal society as ours, where the level of women’s empowerment in making decisions about their own health is very low and where only 15 percent of currently married women make sole decisions regarding their own health care (DHS, 2005), the responsibility for the prevention of HIV through the use of condoms largely lies on men.
On the other hand, though, as the trend shows, if the women who are educated, those in the higher wealth quintile and those in better position to negotiate for safer sex engage in risky sexual behavior, then it’s necessary that a strong and definite behavior change that would make sexual intercourse without using condoms consistently and correctly unacceptable be brought about.
*Names of individuals in this article have been changed.