But, according to a study published in the British Royal Society’s Interface journal last month, this seems to be changing. National surveys show the proportion of young South African men aged 16-24 who reported using a condom at their last sexual encounter leaping from 20% in 1999 to 75% in 2009. This, more than an equally dramatic rise in anti-retroviral treatment, is the “most significant factor” in the fall of new infections, say the British and South African authors of the study.
What the Economist report doesn’t tell us is whether this is a product of:
1. More affordable and available condoms?
2. Education – i.e people just needed to be told that condoms prevent HIV?
3. Observation (+ education) – enough people seeing the consequences of not using them?
4. Women being empowered to demand use?
5. Or a more subtle change in norms?
It always seemed to me that, like most areas of development, SRH work has been plagued by certainty based on plausibility (i.e. this seems like it could be the case, therefore it is, and we must act). But given the complexities of human sexual relations and the way we make decisions about sex (not, cough, always that rationally, or – tragically for too many people – that freely) this has always struck me as severely misplaced.
Knowing of the the shift is heartening. But it also seems critically important to know why it’s taking place.