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Condom use needs to be promoted as part of a comprehensive prevention agenda. An inter-related STI/HIV prevention package includes advocacy, educating the public on STIs/HIV, promoting responsible and safer sexual behaviours, empowerment of women, improving attitudes toward and utilizing behaviour change communication to increase condom use among men and women, providing voluntary counselling and testing services and appropriate referral for treatment and care.
Condom programming should be based upon the needs, perspectives, and sexual behaviours of those at risk of HIV infection and of the surrounding community. Central to ensuring consistent and correct use of condoms is a people-centred approach, which strives to understand user needs including through addressing the socio-cultural and political environments which help shape beliefs and practices. Condom programming should provide information about STIs/ HIV prevention, strive to bridge the gap between knowledge and behaviour, instill a desire to use condoms, ensure correct and consistent use, and monitor user attitudes that might act as barriers to use.
While not sufficient to ensure use, provision of adequate supplies of a quality product is critical. Provision of quality condoms must be dynamic to stay abreast of the ever-changing requirements. Condom stock-outs are detrimental both to potential users and to existing user’s expectations and future compliance. Quality 3 is imperative to ensure effectiveness in STI/HIV prevention, as is the user perception that a quality condom is indeed a reliable product. Adequate supplies of quality condoms requires infrastructure, resources and planning to address forecasting of needs, production of quality condoms in sizes and styles acceptable to users, procurement from certified manufacturers, and logistics management (including safe and timely delivery, safe storage facilities, inventory management, and userfriendly distribution points).
A supportive political, legislative and community environment is an essential component; this includes governmental officials, legislative bodies, religious institutions, community leaders, health providers, teachers, parents, and individuals. Directed advocacy campaigns can help reassure sceptics that condoms are an effective means of protection from serious infection, and that they should be promoted within the context of a comprehensive prevention programme that emphasizes informed, responsible and safer sexual behaviour.
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