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Negative attitudes towards condom purchase and use still exist

There is still stigma around discussion on healthy attitudes and behaviours towards sexual intercourse, particularly consistent and correct condom use.

This contributes to the continued prevalence of STIs and HIV infection in Botswana at a time where HIV still infects many Batswana and is still treated as a public health risk.

Using condoms is the only sure way to protect people from STI infections and other sexually transmitted conditions. But the prices of quality condoms and accompanying products that enhance sexual experiences such as lubricants have gone up. On the other hand, it has surfaced that condoms are not as easily accessible in public health facilities.

A shortage of condoms that started lasted year in Botswana raised fears about the impact on HIV prevention programs and one health official in Phase 2 clinic, Kgomotso Sedie, said that they have to monitor the condoms in their facilities.

'Some people take too many - they can take 10 to 20 instead of two or three. Sometimes the condom disposal container is filled up in the morning but in the afternoon it is empty!'

But not everyone wants to use the cheap and free condoms and prefer quality branded condoms. Even then, there is still an air of embarrassment and shame, especially considering how the condoms are often hidden and their

transaction has a 'hush hush' connotation as if someone is buying an illegal product. However, using condoms is a saving grace that protects individuals from sexually transmitted diseases and unplanned pregnancies.

Thabiso Sethito said that he finds it strange how Batswana claim to be 'conservative' when it comes to sexual behaviour and practices and don't want to celebrate condom use when so many are ravished by HIV.

'We should be open about condom use. I find it disgusting that some people find it 'cool' to have unprotected sex - that is a death sentence! We should make it cool to use condoms and stick to one sexual partner,' he said.

Masego Onkabetse noted that condom use can protect one from nasty sexually transmitted infections. 'That one sexual intercourse session with the wrong person can almost ruin your life - you can end up with an STI or unplanned pregnancy. I once had unprotected sex with one man who claimed he had no condoms and coerced me into unprotected sex.

A few days after sleeping with him I developed a fishy smell 'down there' and went to the doctor and was told I had an STI. I felt dirty and I never ever slept with that man again. We sometimes think unprotected sex is an expression of real love and commitment but it is sometimes just someone taking advantage of you.

A loving person would always maintain consistent condom use and strive to protect you,' she said.

Lerato Tlale said attitude is what matters when it comes to sexual engagements. 'When I meet someone and they are reluctant or do not want to use a condom, I cut them off because it shows irresponsible attitude. I also avoid entanglements, they are dirty, ugly and lead to diseases. I buy and use condoms and don't care who says what - my wellness and life are more important.'

Condom distribution programs (CDPs) are an HIV and sexually transmitted disease (STD) prevention strategy that helps increase the availability, accessibility, and acceptability of condoms in an effort to prevent the spread of HIV. Government has also introduced the test-and-treat system.

Botswana has the world's fourth-highest HIV prevalence. The recent BAIS Preliminary Report released last month indicates that among adults aged 15‐64 years, HIV prevalence ranged from 2.7 percent for females aged 15‐19 years to 52.0 percent for females aged 45‐49 years, and from 1.6 percent for males aged 15‐19 years to 39.0 percent for males aged 50‐54 years old.

In December 2021, Botswana became the first high HIV burden country to be certified by the WHO Global Validation Advisory Committee, as having achieved a critical milestone along the path to eliminating vertical HIV transmission through protective interventions and services that are consistent with international and regional standards on human rights, gender equality and community engagement.