Report: Older men spreading HIV because they wear condoms wrong

As a result, according to NSDCC CEO, Dr Ruth Laibon-Masha, they have in the country’s condom strategy decided to ensure that every sexually active person in Kenya has access to a sustained supply of quality condoms, correct knowledge, skills and motivation to use them correctly and consistently to prevent transmission of HIV and other sexually transmitted diseases and unintended pregnancies.

While addressing delegates at the 7th Maisha Scientific Conference, an international conference that aims to provide a platform for policy makers, scientists, communities, and partners to share knowledge and insights gained over almost four decades of addressing the HIV response, Dr Masha said that the assumption was that only young people did not know how to use condoms, but their findings show that older Kenyan men aged 50 years and above equally do not have this knowledge.

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“We get quality condoms from donors, but the problem is with how they are stored as they go down the supply chain,” she explained, adding that young girls are having sex with older men from a generation that is not used to wearing condoms .

“Some do it inside out , in darkness , apply oil, while some tear with their teeth and puncture them.

Ms Grace Mwangi from the African Development and Emergency Organisation, which serves the rural parts of Kajiado County, agrees with Dr Masha.

“We implement the adolescent and young people program in the area and talk to very many young women who have increasingly taken to intergenerational sex with older men. Initially, we assumed that young people do not know how to wear condoms, but shockingly, we found older people do not know as well, which is why we have decided to teach everyone,” she told Saturday Nation, explaining that the first thing to check is the expiry date of the condom, open it gently from the tip and in a well-lit place, and ensure that you live some space at the tip to accommodate ejaculation.

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“Correct and consistent condom use provide up to 95 per cent protection against HIV, other STIs and unintended pregnancy,” said Ms Mwangi.

A total of 190,110,760 male condoms were distributed in the country in 2021 against a need of 424 million male condoms while 3,090,000 million female condoms were distributed in the same year against a need of 8,206,345.

“This means that we have 14.6 condoms per man per year against global target of 40 condoms per man per year,” Dr Masha said, further explaining that in the last 10 years, the government conducted mapping of potential or existing condom distribution points.

“A total of 17,854 condom distribution points were identified in 47 counties out of which 84 per cent (15,008) were either bars with lodging or without lodging.

Dispensers were accessible in 14 per cent of all identified condom distribution points, including 53 Huduma center.

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Dr Masha addressed Kenya’s heavy reliance on donors.

“The Kenya condom program is heavily donor-funded, requiring Sh 1,117,850,400 with a resource gap of Sh 803,235,120 (71.9 per cent) as of 2021. We also have a dominant public sector free to use condoms accounting for over 84 per cent, a strong social marketing sector at 14 per cent of the total market, and a potential to grow the commercial sector accounting for less than two per cent,” the CEO noted, while urging the country to prioritise manufacturing her own condoms.

Speaking to the Saturday Nation, Ms Mercy Mulwa, a young mother of two boys, says that she got pregnant with her firstborn at 19 years despite using a condom.

“For me, it is about the quality of the condoms we are using as a country, I urge the government to make vaginal rings available in the country for young girls because once they are in place, no one can tamper with them until after 28 days when she can have it changed,” she said.

In 2021, the WHO announced that the dapivirine vaginal ring (DPV-VR) may be offered as an additional prevention choice for women at substantial risk [1] of HIV infection as part of combination prevention approaches.

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“The DPV-VR is a female-initiated option to reduce the risk of HIV infection. To properly use the ring, it must be worn inside the vagina for a period of 28 days, after which it should be replaced by a new ring. The ring is made of silicone and is easy to bend and insert. The ring works by releasing the antiretroviral drug dapivirine from the ring into the vagina slowly over 28 days,” WHO said.

Mercy says discloses that there is still a lot of stigmatisation when it comes to taking pills such as PrEP (pre-exposure prophylaxis) which can reduce chances of getting HIV from sex or injection drug use.

“I come from the ghetto, and when you are seen taking any pill consistently like PrEP, the assumption is you are HIV positive, which keeps many young people off contraceptive pills,” she said.

“Younger girls also fear telling older men to wear condoms, they don’t know how to stand their ground, which is why we need to educate them further,” added Mercy.

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