U.S. Has Increased Global Condom Distribution in Recent Years, Targeting Mostly High-Risk Groups

The U.S. has bought more than one billion condoms over the past two years to help curb the spread of HIV in developing countries, but more than 60 countries still say they do not have enough condoms, the Boston Globe reports. By the end of this year, the U.S. will have distributed 612 million condoms to Africa, Asia and Latin America, the greatest number since 1991, according to the Office of the U.S. Global AIDS Coordinator. Deputy U.S. Global AIDS Coordinator Mark Dybul said the U.S. is "by far the largest supplier of condoms in the world." However, the U.S. recently has come under criticism for allegedly playing a role in a condom shortage in Uganda (Donnelly, Boston Globe, 9/8). U.N. Special Envoy for HIV/AIDS in Africa Stephen Lewis and other AIDS advocates last week said the Bush administration's policy of promoting abstinence prevention programs and cuts in federal funding for condoms have contributed to a condom shortage in Uganda and undermined the country's HIV/AIDS fight. Uganda needs between 120 million and 150 million condoms annually, but since October 2004 only 32 million have been distributed in the country, according to the U.S.-based Center for Health and Gender Equity, also known as CHANGE. Lewis said in a teleconference sponsored by health and human rights groups that "there is no question that the condom crisis in Uganda is being driven and exacerbated by [the President's Emergency Plan for AIDS Relief] and by the extreme policies the administration in the United States is now pursuing." The shortage began in October 2004 when Ugandan President Yoweri Museveni ordered a nationwide recall of condoms that were distributed at no cost in government health clinics under the brand name Engabu, saying they were of poor quality (Kaiser Daily HIV/AIDS Report, 8/30).

Reaction
Dybul said the U.S. recognizes that a "condoms-only policy to prevent the spread of HIV in a generalized epidemic just won't work." He said the U.S. focuses its condom distribution on people in high-risk areas, such as bars, border crossings, brothels and military bases, but does not rule out giving them to other groups at risk. He added that promoting condom use to all segments of society would be misleading for people trying to abstain from sex or be faithful to one partner. However, Lewis in an interview said, "When a virus has spread so widely, it is important to focus on high-risk areas, but it's important also to focus on the whole population." CHANGE Executive Director Jodi Jacobson said the U.S. policy makes it appear as though the country is telling people that "you can distribute condoms only to sex workers, truck drivers and people in bars." Beatrice Were, an AIDS advocate working in Uganda, said, "There is now a stigma attached to the use of condoms. ... Those of us who are promoting condoms are looked at as immoral people, those that are morally dead." However, an 18-page document from the U.S. global AIDS office for overseas missions says that "correct and consistent" condom use should be promoted as part of overall prevention strategies and defines several populations as being at high risk of HIV infection, including married women (Boston Globe, 9/8).