Trinidad roll out condom machines in AIDS battle

by Peter Ischyrion

PORT OF SPAIN, Trinidad, August 31, 2007  – Among the frequently asked questions on the website of the National AIDS Coordinating Committee (NACC) in Trinidad and Tobago is one dealing with the use of condoms in the fight against HIV/AIDS.

“Can a condom protect me from getting HIV the AIDS virus? YES, used correctly and consistently, condoms are the only available barrier to reduce the risk of HIV transmission. Abstaining from sex is safest, but if one chooses to be sexually active, use a condom each and every time.”

Now, having reported “significant progress” in addressing the rates of HIV/AIDS over the last five years, the Trinidad and Tobago government says it will purchase condom vending machines as one of several initiatives to deal with the virus.

Figures released by UNAIDS showed that in 2005, there were an estimated 26,000 people between the ages of 15 and 47 infected with the HIV virus and that the number of people who died from AIDS totaled 1,900 that year.

The good news is that there has been a steady decline in the overall number of new HIV cases, AIDS cases and deaths for several years now. From 1996 to 2004, was a 50 percent decrease in reported deaths due to AIDS, UNAIDS reports.

The predominant mode of HIV transmission in Trinidad and Tobago is heterosexual sex.

NACC technical director Dr. Amery Brown stresses that the idea is not to just deploy machines for condoms, but the initiative must be regarded as part of a “comprehensive prevention programme that also includes abstinence, faithfulness and increased awareness”.

The government said funding for the project would be provided under the World Bank-assisted HIV/AIDS Prevention and Control project in conjunction with the European Union.

A recent study by the Trinidad-based Caribbean Epidemiology Centre (CAREC) in six unidentified Eastern Caribbean islands showed that more than half of the surveyed males aged 15 to 24 years had had more than one non-regular sex partner in the preceding 12 months, compared to approximately one-quarter of the surveyed females in the same age group. The figures were lower for older persons aged between 25 to 49 years.

But the study also found that approximately 7 in 10 males reported using a condom the last time they had sex with a non-regular partner; with CAREC stating “this result was consistent with the data from the younger and older populations.”

“It was striking that although at least 8 out of 10 respondents knew that condom use during sex was protective against HIV infection, less than half of the sexually active male respondents reported consistent condom use with casual partners,” the study said.

“For females, condom use at last sex with a casual partner was reported by approximately half of the women aged 15 to 24 compared to less than 40 per cent of women aged 25 to 49 years. Less than 1 in 5 women reported consistent condom use with casual partners,” it noted.

“These data point to high risk behaviours that are practised despite the high knowledge that healthy looking persons can be infected with HIV and that condoms can protect against HIV transmission. The gender differences highlight the vulnerability of women to HIV due to low practice of known effective prevention methods,” the study found.

A research effort involving various stakeholders, including hoteliers and event organisers, is now being undertaken in Trinidad and Tobago focusing on possible venues for the machines.

But even as authorities move towards implementing the new initiative, they will have to overcome opposition from several prominent religious organisations.

Nobel Khan, the public relations officer of the Inter-Religious Organisation (IRO), an umbrella group, said that while the matter had not yet been discussed by members, he believed that the introduction of the vending machines would be a cause for concern.

“The faith-based tradition encourages sex within marriage and implementation of the machines would send a message of a conflict situation and contradiction of this practice,” he said, arguing that the machines would encourage the practice of illicit sexual activity outside of marriage.

Yacoob Ali, president of the Anjuman Sunnat-UlĂ»Jamaat Association (ASJA), a leading Muslim organisation noted that “ASJA would not be supporting it”, while the Sanatan Dharma Maha Sabha (SDMS), the main Hindu organisation here, viewed the introduction of the machines as sending a wrong message to young people.

“The Hindu community and the Maha Sabha have always advocated the avoidance of active sexual activity before marriage and if this is adhered to there will be no need for condom vending machines,” said SDMA general secretary Satnarine Maharaj.

The Roman Catholic Church has also indicated that it would not be supporting the initiative. “The position of the church with respect to the matter pertaining to condom use and condom vending machines is already well-known,” said Monsignor Cuthbert Alexander, the vicar for communication.

But Health Minister John Rahael says the government will not be deterred, adding that “government looks at what is in the best interest of the vast majority of people”.

The Ministry of Education curriculum guide for “Health and Family Life Education” encourages children to “adopt an abstinence policy as the only safe method of protection from HIV/AIDS and other sexually transmitted infections and diseases”.

But many, including the media, have questioned whether abstinence alone is the responsible way forward.

“In a society where approximately one in every 25 persons may be infected with HIV/AIDS, the introduction of condom vending machines may be the practical way to go,” said Newsday in an editorial last week.

“Every country which has succeeded in containing HIV has done so on the basis of a no-nonsense public education programme which emphasises condom use, as well as fidelity and abstinence,” the paper said, adding also “it is easier to persuade people to put on a condom than it is to persuade them to not have sex, or even, in certain cultures, to have sex with only one person.”

When he delivered the national budget of this oil-rich republic on Aug. 20, Prime Minister Patrick Manning said that the efforts of his administration over the last five years had resulted in reducing deaths caused by the virus by about one-half even as he acknowledged that “AIDS remains the leading cause of death in the 15-44 age group.”

“The government therefore will continue to remain vigilant as it seeks to further develop and consolidate a comprehensive and collaborative approach for treating HIV/AIDS,” Manning said, noting that over the next 12 months it would be extending free HIV/AIDS treatment to six major centres.

“In addition, there will be improvements in both the procurement and distribution of drugs to treat HIV/AIDS, as well as the institutional strengthening of laboratories,” he told parliament.