By Dr Marnie Vujovic, adolescent psychosocial programme manager at Right to Care
Unprotected sex is the most common route of HIV infection among young people. Condoms have been the mainstay of our Sexual Reproductive Health (SRH) initiatives because they offer protection not only from HIV, but from other sexually transmitted infections (STIs) and from unintended pregnancies. But getting young people to use condoms is easier said than done.
It is not enough to tell a young person to use a condom, rather we need to understand some of the reasons they don’t. Girls and young women are often the ones who get education on contraception at a healthcare facility. But unless they opt for a female condom they still need to discuss the use of a male condom with their sexual partner.
In South Africa, gender inequality makes it difficult for young women, especially those the ages of 15-24 years old, to negotiate condom usage and the result is that they don’t always practice safe sex. They also fear that insistence on condom use might suggest that they are unfaithful as condoms tend to be associated with casual sex.
To promote condom use as a key intervention in preventing HIV, pregnancy and other STIs, the provision of comprehensive sexual reproductive health (SRH) services are required.
South Africa has made important headway in providing SRH services, but given the scale of our HIV epidemic amongst young people, and especially young women, our efforts need to be scaled up.
Even when young people are not sexually active they need sex education, and contrary to popular belief, this does not mean they will engage in sex by learning about it. Sexually active learners should have access to contraception via school health nurses or should be referred to a nearby health facility.
In South Africa, the National Adolescent and Youth Health policy emphasises the need to improve the contraceptive mix for young people, and this includes offering both male and female condoms. A package of school health services in the Integrated School Health Policy makes provision for health education and promotion and suggests the necessity, particularly in secondary schools, of addressing sexual and reproductive health including contraceptives.
We need to sensitively address issues and promote condom usage. We need to be talking about how to use condoms, lubricants and how to bring respect into relationships. We need to make condoms sexy – to some extent this has been recognised with the availability of flavoured condoms – but we can do more.
Many people use condoms as part of foreplay and integrate the successful application of the condom together, as a sharing and intimate experience before intercourse begins.
At the same time, a woman that may not want sex but finds herself in a position where it is difficult to say no, should at least be asking her partner or rapist, to use a condom.
Here are some important contact numbers for women of all ages who feel they need support in any aspect of their lives right now:
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