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Promoting Condom Use
Though condom use in the country has been promoted since the 1960s under the National Family Planning Programme for prevention of unwanted pregnancies, its promotion received major impetus and significance with the outbreak of HIV. With nearly 86 percent HIV transmission through unsafe sex in the country, NACO advocates and promotes condom use as a safe sex practice for prevention of STI/RTI and HIV, in addition to protection from unwanted pregnancy.
Condom promotion under NACP-I & II led to an increase in the awareness about its consistent use in HIV/AIDS prevention. The availability of free supply, subsidised and commercial brands of condoms was also increased during these years. However, this did not have a significant impact on its use. Given the significant role of condoms in the prevention of STI/HIV infections, NACO is faced with the challenge of promoting its use for controlling the epidemic. In this direction, apart from stepping up condom advocacy, NACO has launched new management and distribution initiatives.
Fig.1 Condom sales off-take in million pieces from 2001-2006
With a distribution target of 3.5 billion condoms every year by 2010, NACO has galvanised condom promotion at three levels: free supply in STI/RTI clinics, by way of targeted interventions through social marketing, involving government medical machinery at the state level, and by promoting and facilitating commercial sales through hitherto unconventional sales outlets, and raising their number to three million by 2010 from the existing one million. Currently, about 2.25 billion condoms are distributed per annum (see Fig.2).
Fig.2. Condom Distribution
A. Year 2006: 2.25 billion condoms
B. Year 2010: Target 3.5 billion condoms
Objective
Under NACP-III condom promotion continues to be an important prevention strategy. The programme seeks to:
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Increase condom use during sex with non-regular partner, which is the key to limiting HIV spread through sexual route.
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Increase the number of condoms distributed by social marketing programmes.
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Increase the number of free condoms distributed through STI and STD clinics, reaching those who are at the highest risk of acquiring or transmitting HIV.
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Increase access to condoms, especially to men who have sex with non-regular partners.
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Increase the number of commercial condoms sold.
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Increase the number of non-traditional outlets for socially marketed condoms, e.g., paan shops, lodges, etc. in strategically located hotspots of solicitation.
Social Marketing
In view of the stagnant growth in condom use, NACO has devised a national level social marketing plan in partnership with HLFPPT, a not-for-profit organisation promoted by Hindustan Latex Limited, a Government of India undertaking. The plan is promoted and coordinated by Technical Support Group comprising experts at the state level.
The TSG implements social marketing programmes through State Medical Officers (SMOs). Under the programme, the states are required to implement an IT-enabled condom tracking system, and manage a generic communications campaign for condom promotion. The programme also requires states to reduce wastage of ‘free supply’ condoms, set up appropriate storage facilities, ensure quality checks, re-examine the promotional subsidy on socially marketed condoms, etc. Social marketing brand “Nirodh Deluxe” is also planned to be repackaged and repositioned to boost condom use.
Innovative Approaches
NACO has launched a number of innovative approaches in promotion of condom use. Among them are:
a. Condom Vending Machines (CVM): NACO established 11,025 CVMs in 10 states under a national programme. The CVMs provide anytime access to quality condoms in a non-embarrassing situation. Another 11,025 CVMs are being installed in all the metros and major cities across the country in Phase-II of this programme commenced in 2007. The programme will be scaled up as per demand and requirement.
b. Female Condoms (FC): A pre-programming assessment for social marketing of female condoms is being implemented in selected locations of eight states to understand the acceptability, willingness to pay and impact on dual protection. Ministry of Health and Family Welfare has funded the procurement of 500,000 FC to be promoted amongst FSW in six states and among general population in two states. On the basis of this pilot study, the programme will be scaled up in other sites of targeted interventions.
c. Thicker, more lubricated condoms: A thicker, more lubricated condom branded “Spice Up” will be launched in collaboration with HLFPPT to cater to special needs of the high risk groups. These condoms will be socially marketed in the targeted intervention sites.
Guiding Strategies
NACP-III plans to enhance condom use through specific strategies for high risk groups: clients of sex workers, migrants, truckers (bridge population), people living with HIV/AIDS and general population on one hand, and its integration with prevention services like STI care, counselling and prevention of parent to child transmission on the other. The programme objective is to increase consistent condom use among men who have sex with non-regular partners and high risk groups to near 100 percent.
Better Access in Rural and Remote Areas: Under NACP-III, NACO seeks to strengthen condoms availability by integrating social marketing with targeted interventions (TI), integrating condom supply chain management with the networks of major cooperatives and FMCG companies, and developing village level interface with self-help groups, post offices, rural banks, etc., besides skill building of health/link workers.
Mainstreaming Prevention: For achieving significant increase in condom use, NACO, through its mainstreaming initiatives has achieved the support of various ministries and departments in promoting condoms as a safe sex habit. Its objective is to increase condom use through intensive demand generation and supply efforts.
Condom Communications: All channels of communication will be used to promote condoms. While normalisation of condom use is accorded prime importance, barriers to condom use will be addressed. Irrational beliefs will be identified and addressed. |