Experts are sounding the alarm over continued low condom usage by South African youth, particularly as it contributes to the high rate of teenage pregnancies and HIV infections among adolescent girls and young women. 

The South African National AIDS Council (SANAC) says around 350,470 females between the ages of 15-24 years were diagnosed with HIV in 2022. This is as SA marks Sexually Transmitted Infections(STI)/Condom Week.

Condoms are available at no cost at public healthcare facilities and some public buildings. But Treatment Action Campaign (TAC) Chairperson, Sibongile Tshabalala, has revealed despite condoms being accessible in public health facilities across the country, there are still not enough of them. 

Roll out female condoms

Tshabalala pointed out that Gauteng, Mpumalanga and KwaZulu-Natal have experienced shortages in the last few months. She emphasised that key populations are also missing out.  She says the inadequate provision of different types of condoms across the public sector is a significant concern that needs urgent attention. 

“When you look for femidoms and other kinds of condoms, they are not available in public sectors. So, it is still problematic,” she says. 

Health-e News spoke to some youth who are sexually active about condom usage. They all agree that condom use is vital and safe sex is the responsibility of both partners.

Mashudu Mulaudzi, a 22-year-old from Tshikhudini village, shared that she fell pregnant and contracted gonorrhoea two years ago.

“I started having sex when I was 17 years old. My then boyfriend and I never used a condom as we feared going to the local clinic to collect them. But we knew the risks we were taking,” says Mulaudzi.

Mulaudzi says she suspected she was pregnant but delayed going to the clinic out of fear of being shamed. And she continued practising unsafe sex.

Fear of being shamed

“I only went to the clinic when I was about three months pregnant. I feared that the nurses were going to insult me for sleeping around without using protection. When tests were conducted, I learnt that I had also contracted gonorrhoea. Luckily, I tested negative for HIV.” 

The Vhembe TVET college engineering student says she now practises safe sex.

“I am no longer even ashamed to collect condoms everywhere I see them, whether at school or even at a health facility. Even the guy I am dating now knows that without a condom, there is no sex.” 

Fulufhelo Matshotshi, a 20-year-old student, says she prefers to use condoms she buys over the ones available at clinics. Matshotshi says there must be ongoing awareness campaigns on condom use for the youth.“I believe there is still an urgent need to educate people, especially the youth, about safe sex as most of them only learn when they have already contracted an STI or fall pregnant.”

Matshotshi adds she regularly tests for HIV. “As youth, we must make testing for HIV a hobby. That way, we will know our statuses.”

Condom use a shared responsibility

Meanwhile, James Mashau*, a 31-year-old, emphasised that carrying and using condoms are everyone’s responsibility. 

“Look, I have slept with several women since I became sexually active as a teenager. Some never asked me to use a condom. But I have also dated women who refused sex without a condom. So, what I am saying is that it should be everyone’s responsibility to carry and use a condom,” says Mashau.

He says people in relationships must also use condoms. “There are so many diseases which one can contract by not using a condom, even from those we trust. I have had an STI in the past. But I am lucky that I am still HIV negative”.

The World Health Organisation states that when used correctly and consistently, condoms offer one of the most effective methods of protection against STIs, including HIV. Condoms should be used during all vaginal and anal sex.

Increased chances of HIV and STIs

Dr Kim Jonas, a specialist scientist in the Health Systems Unit of the South African Medical Research Council (SAMRC), says their research shows 52% of adolescent girls and young women who had ever had sex accessed a male condom during the year before the survey, 27% accessed a female condom, 41% accessed another form of modern contraception, and only 48% had ever used a modern contraceptive

“Approximately half of the young women participating in our survey were at risk of HIV acquisition or onward transmission. The use of a contraceptive method plus condom (dual contraception) was very low among the participants, meaning that young women may be preventing unintended pregnancy but are at risk of contracting HIV because they are not practising dual prevention,” she says.

Jonas says access to sexual and reproductive health services for young people must expand beyond the “traditional” health facilities into the schools.

“The schools because that is where many girls are; to the community/city hall where it is safe and convenient for young girls to come. Provide comprehensive, person-centred, and youth-responsive sexual and reproductive health counselling and services.” – Health-e News

*Indicate that a name has been changed.