The HIV/AIDS pandemic continues to escalate with an estimated 5 million new infections in 2001 alone.

To date, no preventive vaccine or cure exists for HIV/AIDS. While treatment with anti-retroviral drugs (ARVs) has the potential to significantly improve the quality of life for people with HIV/AIDS, ARVs remain inaccessible and unaffordable to most of those infected. Since the vast majority of adults and young people acquire HIV/ AIDS through unprotected sexual intercourse, prevention through responsible and safer sexual behaviour, including condom use, provides one of the main lines of defense against infection.

The risk of HIV infection is 2 to 9 times greater when other STIs are present. Consistent and correct use of condoms, both male and female, is a proven highly effective means of protection from HIV infection, most other sexually transmitted infections (STIs), and unintended pregnancy. There is sufficient evidence to demonstrate that consistent and correct condom use reduces the risk of HIV infection considerably, ranging from 60% to 96%. International consensus documents affirm prevention as the mainstay of any response to the HIV epidemic and condoms as an essential part of prevention programming.

Condom programming as a prevention strategy, however, must not be construed as mere provision of a commodity. It involves the equally important and interrelated components of informed choice, empowerment, a supportive environment, demand and supply. Unfortunately, elements of demand, particularly user needs and preferences, are often neglected.

Condom programming requires a dynamic interaction and appropriate balance between supply and demand within a supportive environment. Their intersection represents condom use¹ (see diagram - Comprehensive Condom Programming). The environment, consisting of institutional capacity, the commitment of leadership, sufficient resources, and effective collaborative mechanisms, is the critical operating framework through which access to and use of condoms is ensured.