Evaluating the potential impact of condoms and vaginal microbicides to reduce the spread of HIV.

Since its emergence in the 1980s,the HumanImmuno-deficiency Virus(HIV),the causative agent of Acquired Immune Deficiency Syndrome (AIDS) has claimed the lives of millions of people(20 million), and continues to exert significance socio-economic and public health burden, around the globe. The current UN AIDS report estimates about 38.6 -46 million people were living with HIV at the end of 2005, and 4.1 million new infections were recorded in that year. More than one-half of the 38.6 -46 million people living with HIV/AIDS are women, with more than 90% of all adolescent and adult HIV infections resulting from heterosexual intercourse. In Southern Africa the epidemic is exploding and non-levelling due to several factors; deteriorating health systems,poverty, traditional beliefs, increased substance abuse, sexual violence, high population mobility, stigma and discrimination and low risk-reduction education. Although the HIV/AIDS threat is great, there has been alot of research on how to help people protect themselves from contracting the virus(primary prevention,for example condom use, vaginal microbicides, abstinence, etc) and how to prevent and minimize the health and psychological consequences of those living with the infection (secondary prevention). When the HIV pandemic first became visible in the early 1980s, global concern about the gravity of the virus began to fuel research on how to prevent transmission. Both HIV and efforts to respond to the disease surfaced early in Uganda. The prevention effort in Uganda, which has since spread to other countries in Sub-Sahara Africa and beyond, was to be faithful, abstinence and use of condoms. While the idea of abstaining from sex had some success among young, unmarried people, the refusal of many married men to remain faithful to their often-monogamous wives made the use of condoms the only option feasible. Knowledge of condoms as a method of preventing pregnancy and HIV/AIDS is relatively good. However, there are many real and perceived barriers to condom use especially in stable sexual relationships. In stable long-term relationships, resistance to condom use is strongly related to its association with STDs(including HIV/AIDS). Men and women do not see the need for condom use in such relationships, maybe seen as a clear sign of infidelity. These attitudes represent major obstacle to the use of condoms as a method of protection. Equally difficult to measure is the proportion of individuals who use condoms consistently and correctly. While condoms may be readily available, the consistent and correct use also depends on individual’s attitudes, beliefs and how informed they are on the risks associated with improper use of condoms