The battle against HIV and AIDS has often triggered fights among communities trying to shield their values and belief systems from being compromised. There are many people who still view contraceptives such as condoms, as destructive to the moral fibre of their communities. There are also countless myths regarding their effectiveness or otherwise and this skepticism needs to be reversed, as it is as contagious as the virus itself. Some people feel, for example, that the social marketing and distribution of condoms weakens the sanctity of sex and encourages promiscuity. However, there is more to the issue of contraceptives than some people would allow themselves to believe.
A study on condom use and abstinence among unmarried people in Zimbabwe, carried out by Ravai Marindo, Steve Pearson and John B. Casterline (2003), discovered (from focus-group discussions) that young people often adopted prevention strategies not out of their own informed choices, but because they felt obligated to protect their parents’ interests.
The common, uncompromising attitude of adults was the stringent stance of abstinence and the researchers felt that this moral conflict had the effect of forcing young people into concealing their condom use so as not to disappoint their parents. Thus publicly, they emphasised abstinence. Creating such moral conflicts in our youth reduces their choices in reproductive behaviour and without adequate health education, they might misuse contraceptives or at worst, not use them at all.
The best strategy is broad-based health promotion as it is all embracing. There is no suggestion whatsoever of promoting sex, but rather it is an effort to encourage sexual responsibility that begins at the root of it all, abstinence. Eldis, a web-based resource for development information, outlines the key guidelines to an effective, broad-based health promotion strategy. For example, peer education programmes present the opportunity for young people to voice their opinions regarding sexual and reproductive health issues. Through these programmes, young people get sustained knowledge about both abstinence and condom use, and get to appreciate the need for behaviour change. This can be in the form of increased contraceptive use or in decreased sexual activity.
The mass media also has an active role to play in exploring sex education and setting the agenda for debate, which culminates in a concrete understanding of the challenges that people face regarding HIV and AIDS. In addition, youth development programmes provide the youth with an opportunity to become actively involved in their communities and acquire leadership skills, which will inspire them to take control of their lives and avoid risks that will harm their future.
The issue of morality and what is necessary for certain contexts is another thorny subject that needs to be addressed. The Catholic Institute of International Relations (CIIR) in its statement entitled ‘HIV and AIDS; Values, Responses and Practices’ (2002) explained its position regarding HIV and issues around tackling HIV. It acknowledged the church’s values regarding sexual responsibility, fidelity and chastity, as well as the fact that respect within relationships and mutual responsibility breeds greater equality and thus, assists in reducing HIV infection. However, CIIR felt that with regards to condom use, the church had failed to recognise power and gender relations. CIIR as an organisation emphasizes that at times condoms are a life-saving option and consequently, informed condom use should be encouraged.
Nor should the debate overlook the significance of condoms in family planning. Rapid population growth puts a strain on resources and can lead to widespread disease outbreaks. Nigeria has made projections into the future to make sure that there are sufficient provisions of contraceptives to curb rapid population growth. In a Federal Ministry of Health document entitled ‘Projections for Contraceptives, including Condoms for HIV and AIDS in Nigeria: Determining the Needs and Cost of Contraceptives for Nigeria 2003 – 2015’, it is acknowledged that the high infant mortality rate is due to the fact that many Nigerian women do not adequately space or limit their children. Some are also unaware of the methods required to enable them to achieve effective family planning. In this case, the distribution of contraceptives and condoms ceases to be a moral concern, but is rather a necessary health practice to reduce infant and maternal mortality. Contraceptives can play an essential role in child spacing and should be encouraged for family planning purposes.
At times we have to allow ourselves to be governed by a degree of reasoning, consideration and compromise. We are fighting against HIV and AIDS. Never should that fight degenerate into a fight among ourselves. HIV and AIDS is a global responsibility requiring global action. We should be seen as playing our part, rather than attempting to theorize on where it came from and pointing fingers. Guilt and denial about sexual intercourse outside marriage does not support healthy decision making about reproductive issues in our societies. Let us accept that we have a serious problem which needs our commitment to solve. Let us not trivialize HIV and AIDS. The simplest thing to do is act.
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