Who’s Talking Condoms?

A recent Classic105’s “Busted” (Classic 105 is an FM radio station in Kenya and "busted" is one of its programmes designed to shame cheating spouses and/or those in relationships) must have mind-boggled HIV Programmers as it brought out a huge gap in Prevention - the Condom Programming. This is how the story went:

 A married man sends an email to “Busted” wanting to find out what his wife is up to. Suspicious about her late working hours, he pins this on something going down between his wife and her boss. Ciku (show host) calls up the guy (Agnes’ husband) and after getting some clarifications, she hits the road with a “very good story”, I must say. Ciku calls up Agnes and introduces herself as the legally married wife of Nelson – Agnes’ boss. ‘Nelson’s wife’ does not bother fighting over her husband because Agnes has just denied any intimate relationship with her boss. Calmly, Nelson’s wife warns Agnes of Nelson’s HIV infection and hell breaks loose – “Oh, my God” is all that Agnes could exclaim repeatedly.

What about Agnes’ husband? He probably got a chill or two up his spine – supposing the HIV story was true? Has he been protecting himself? Have they ever used condoms on their marital bed – and this is the crux of the matter! Men and women go on a rage about a sexually transmitted infection or even unintended pregnancy yet they shudder at using a condom with a spouse or their sexual partner(s).

While the National AIDS and STIs Control Programme (NASCOP) is busy promoting HIV Counselling and Testing (HCT) trying to get a million Kenyans tested, new infections are happening, increasingly among married couples (KAIS, 2007). On the other hand, the National AIDS Control Council (NACC) jointly with other development partners promotes faithfulness in marriage by discouraging ‘Mpango wa Kando’ – Multiple Sexual Partnerships (MCP). Now, faithfulness is a virtue but it is obviously, a less travelled and overgrown footpath in Kenya! Most HIV prevention programmes have targeted youth, sex workers, Men who have Sex with Men (MSM) and long-distance truckers terming them high risk and most vulnerable groups. The Modes of Transmission (MoT) study, 2008 revealed that nationally, 44 percent of new HIV infections occur in unions and steady partnerships as shown below:

National Incidence of HIV and % Incidence by Mode of Exposure for Kenya

	Percent of New HIV Infections
Groups	National	Nyanza	Nairobi	Coast
Heterosexual sex within union/ regular partnership	44.1%	38.5%	37.4%	37.9%
Casual heterosexual sex	20.3%	30.5%	23.0%	14.9%
Sex workers and Clients	14.1%	23.1%	14.7%	18.2%
MSM and Prison	15.2%	6.0%	16.4%	20.5%
Injecting Drug Use (IDU)	3.8%		5.8%	6.1%
Health Facility Related	2.5%	1.9%	2.7%	2.3%
Number of New Infections	76,315	25,195	10,155	6,656

Source: Modes of Transmission, 2009

As can be seen above, heterosexual sex within unions and regular partnerships (the likes of Agnes) are the biggest culprit in new HIV infections across the country.

The Classic105 story confirms that MCP is alive in Kenya yet nobody is promoting condom use among married couples. According to KAIS and MoT, male circumcision and MCP are two cultural factors most associated with the HIV epidemic in Kenya. MCP is actually the primary driver of HIV infection in Kenya.

Let’s face it, Kenyans are seeking sexual pleasure wherever it can be found – the marital bed, a couch, the carpet, the hard floor or pavement or even a bedbug inflicted lodging mattress! As can be seen from the above graph, new HIV infections have been on an unrelenting upward trend since 2002.

Indeed, HIV is affecting the matrimonial bed at a great speed and in deafening silence and it is about time Kenyan couples embraced protected sex. Condoms protect against STIs/HIV and unplanned pregnancies – they are the only ones that offer dual protection.

The NACC should launch a national month-long safer sex campaign in December considering that the World AIDS Day falls on first of December every year. Let’s promote condom use as we seek other strategies to reduce MCP.