title: Progress and challenges to male and female condom use in South Africa.
abstract: South Africa has responded to the sexually transmissible infection and HIV epidemic with a rapid expansion of its national-level public sector condom program. Male condoms are available widely at no cost in the public sector, with expanded access via social marketing and the private sector. The female condom program is one of the largest and best established globally. National surveys show progressive increases in rates of condom use at last sex. However, inconsistent and incorrect condom use and the likelihood that condoms are discontinued in longer-term partnerships are some of the challenges impeding the condom program's successes in the fight against sexually transmissible infections and HIV. This article reviews the current condom program, related guidelines and policies, and the existing data on male and female condom use, including distribution and uptake. We discuss the main challenges to condom use, including both user and service-related issues and finally how these challenges could be addressed.
authors.affiliation: MatCH Maternal, Adolescent and Child Health, Department of Obstetrics and Gynaecology, University of the Witwatersrand, 151 Juniper Road, Overport, Durban 4091, South Africa. mbeksinska@match.org.za
authors.forename: Mags E
authors.initials: ME
authors.lastname: Beksinska
authors.forename: Jennifer A
authors.initials: JA
authors.lastname: Smit
authors.forename: Joanne E
authors.initials: JE
authors.lastname: Mantell
mesh_terms: D017280:Condoms / Q000706:statistics & numerical data*; D003268:Contraception Behavior / Q000706:statistics & numerical data*; D005260:Female; D015658:HIV Infections / Q000453:epidemiology / Q000517:prevention & control; D006297:Health Services Accessibility / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008389:Marketing of Health Services; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D017060:Patient Satisfaction; D012309:Risk-Taking; D012725:Sexual Behavior / Q000706:statistics & numerical data*; D012749:Sexually Transmitted Diseases / Q000453:epidemiology / Q000517:prevention & control*; D012924:Social Conditions; D012959:Socioeconomic Factors; D013019:South Africa; D035862:Vulnerable Populations / Q000706:statistics & numerical data