Swaziland: Tackling low condom use dramatically

*This article is from PlusNews: Global HIV/AIDS News and Analysis

MANZINI, 20 May 2008 (PlusNews) - Why are condoms so unpopular? This question has baffled and discouraged health experts for a decade, but in Swaziland the mystery of why men and women refuse to use condoms is slowly being unravelled by a project that is getting Swazi men to open up about their condom use, or lack thereof.

Much has been said and written about the myths and misconceptions inhibiting condom use, but little has been done to reflect these realities in existing HIV/AIDS awareness and prevention campaigns.

Now, an initiative led by AIDS activist and health motivator Hannie Dlamini, and the National Emergency Council on HIV/AIDS (NERCHA), a government body that distributes grants to AIDS organisations, is hoping to change this by getting to the bottom of men's attitudes towards sexual health.

Swaziland's first Demographic Health Survey, in 2007, found that 26 percent of sexually active Swazis were infected with HIV. Although almost 99 percent of survey participants said they knew about the disease, nearly half admitted having multiple sex partners and having sex without condoms.

"Men in Swaziland do not use condoms. They are distributed all over, but they are not used," Dlamini told IRIN/PlusNews.

For the past three years, the NERCHA project has covered two of Swaziland's four regions: the populous central Manzini, the country's commercial hub, and Hhohho region in the north, where the capital, Mbabane, is located. Next on the itinerary are Shiselweni in the south and Lubombo in the east.

The programme has adopted a traditional communications approach, rather than the standard method of using questionnaires, to amass data. To get the men talking, Dlamini and dramatist Modison Magagula looked to traditional Swazi customs that are still largely observed by Swazi men in rural areas, and understood by all Swazi men.

"We recreated the sihonco. This is the enclosure, like a small kraal [cattle pen], where the men go to roast meat, smoke traditional weeds, and discuss things. Women do not enter the sihonco, just as by custom men do not enter the women's special huts. We call the AIDS awareness programme 'kudliwe inhloko' and that is the SiSwati term that means when men sit around and talk amongst themselves," Dlamini explained.

Men in Swaziland do not use condoms. They are distributed all over, but they are not used.

Magagula's drama troupe performs a playlet covering a specific issue, like men involved with under-age girls, which is the starting point for the discussion that follows.

About 8,000 men have participated thus far, but the organisers intend to make this an ongoing project that would eventually reach all Swazi men, to inform them about the facts on AIDS and counter peer pressure and the prevailing myths about the disease.

Hannie Dlamini commented that such word-of-mouth misinformation often served to fill the vacuum of factual knowledge, because there were almost no health educators out there regularly meeting with communities, especially in remote rural areas [...]

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