Special Report by Paul Adepoju
Condoms, public health experts believe are to a large extent the most popular and widely accepted method of safe sex since it has become almost impossible to preach abstinence without being taunted.
Furthermore, they are the cheapest tools in the global fight against HIV/AIDS and in many parts of the world including Africa condoms are freely distributed to everyone who care to have one.
Several results of public health studies in different parts of the world also showed that increasing acceptance of the use of condoms is strongly associated with reduced rates of unwanted pregnancies and new HIV infections. But like several aspects of sex and health, the use of condoms is also at the center of controversies ranging from its scientific effectiveness to spiritual appropriateness.
In Africa, safe sex advocacy is at the core of most HIV/AIDS prevention measures with more donor agencies, non-governmental organizations, public and private sectors and concerned individuals aggressively distributing condoms to Africans at all levels, most especially those at the grassroots.
In Nigeria, HIV incidence is highest in areas where the people still practice cultures of indiscriminate and unprotected sex although several recent studies had also showed similar results in areas where there is high acceptance of safe sex.
Isola is a twenty five-year old young man who recently tested positive to HIV-1 in South West Nigeria. He said he observed all the rules (apart from abstinence) but still got infected.
“I observed necessary precautions because it was my first time. I bought two condoms and wore one appropriately. Yet I got infected. It’s either the use of condoms is not effective or condoms being sold in Nigeria are substandard. While I can’t say what went wrong, I’ll live with that burden for the rest of my life,” Isola told HealthNewsNG.
Toyin is another Nigerian who is blaming unreliable condoms for her woes. She said she got pregnant though her boyfriend wore a condom.
“I’m sure he wore rubber (condom) because I always insist every time we do it. I’m a student nurse so I know what could happen if I engage in unprotected sex. The condom didn’t break and was intact when we finished so I don’t know how it happened. Thank God I only got pregnant and not the dreaded virus,” Toyin said.
On what could have gone wrong in Isola’s case, Dr. Ayo Ayinde, a virologist said he might have bought an expired condom.
“I think he bought a low quality condom or an expired one because this is something that is used daily by millions across the world. He probably didn’t look at the expiry date on the pack,” Ayinde said.
On the scientific basis of his assertion, he said the strength of an expired condom is not as strong as an unexpired one.
“If you look at the virus, you would see that it is very small and the materials used in making the condom need to be tightly interlinked to prevent the virus from slipping out,” he said.
For Toyin, he said an unnoticed damage might have occurred.
“When you are having sex, I’m not sure you would remember to look at the condom very closely with magnifying lens. Whether microscopic or macroscopic, a sperm cell which is very small could have escaped from the condom to fertilize her egg. This could also be the case if substandard condom was used,” he said.
He accused local pharmacies in Nigeria of stocking and selling expired and substandard condoms.
“The Standard Organization of Nigeria (SON) doesn’t go to the local pharmacies that Nigerians go to when they want to buy condoms. Major forms of check end with the manufacturer. Many things could go wrong during packaging, transportation and on the shelf,” he said.
A visit to some local pharmacies in south west Nigeria showed that many owners and operators of the pharmacies don’t have sufficient information on the proper handling of condoms.
When asked how long condoms could spend on shelves before they become unsafe to use, many of the operators could not answer satisfactorily.
Pharm. Amao Akintade, who operates a major pharmacy outlet in Ibadan, Nigeria said he wasn’t surprised the local operators couldn’t convincingly say when the condoms are unsafe to sell to Nigerians.
“They are operating the pharmacies as businesses. Do you think they will gather the expired condoms and just throw them away? I don’t think so. It is not good for business because there is not much profit on the sale of condoms. So they will sell even the expired ones to unsuspecting buyers who are under the strong effect of sex hormones,” he said.
He therefore enjoined stakeholders in the control of HIV/AIDS in Nigeria including the SON and ministries of health at all levels to support the control of HIV/AIDS by intensifying efforts that would make sure that only top quality condoms are sold in Nigeria.
He said: “It is obvious that there is disparity in quality. Durex condoms are more expensive than Gold Circle condoms. Government and other relevant agencies must make sure that irrespective of the cost, every condom being sold in Nigeria must confer adequate protection.”
While this may be an inundating task, many experts said condom manufacturers could guarantee safety by investing more in condom research.
HIV/AIDS researcher, Oluseun Adeogun believe the world could tackle the challenge of leaking condoms by developing condoms that becomes unusable immediately they expire or are exposed to harsh conditions that could make them unsuitable for use.
“Such condoms don’t need much control checks or quality measures. Once they are unsafe, they will become degraded automatically. This should be the new focus for condom developers and HIV researchers. It is not a vague concept but something that is already being used in other fields,” he said.