By Echey Ijezie
The International Condom Day is observed annually on 13 February and there is nothing more critical at this point than the collective call for enhanced HIV prevention everywhere in the world. This is even more significant for us at AIDS Healthcare Foundation (AHF) because we recently celebrated a significant milestone of over two million lives now receiving HIV care globally. As the largest provider of HIV/AIDS medical care worldwide, AHF remains steadfast in its commitment to pioneering treatment and advocacy, ensuring access to care regardless of an individual’s ability to pay. This milestone also highlights our modest but important contribution to the fight against HIV/AIDS in Nigeria.
The recent dwindling funding threatens HIV prevention initiatives, this is why condom access must be prioritised. While some nations may justify cutting back on aid and funding, Nigeria and indeed many African nations faces the risk of increasing HIV infection rates unless new strategies are adopted to expand condom availability and education. The World Health Organization (WHO) reports that about 1 million STI infections occur globally every day. Although the presence of PrEP has revolutionised HIV prevention, it does not protect against other STIs. This makes it essential to balance messaging on the importance of both condoms and PrEP. The Joint United Nations Programme on HIV/AIDS (UNAIDS) in their 2024 Global AIDS Update report gave some grim statistics [Ref: UNAIDS].
In 2023 alone, approximately 3,500 people became newly infected with HIV daily, totalling 1.3 million new infections for the year. In a recent press release, UNAIDS asserted that condoms remain one of the most effective and low-cost tools for preventing HIV, with a 98% effectiveness rate when used correctly and consistently. Globally, condom use has averted an estimated 117 million new HIV infections between 1990 and 2019 [Ref: UNAIDS]. However, recent data indicates a decline of 6-15% in condom use across multiple countries, according to Demographic and Health Surveys (DHS), the Condom Landscape Analysis, and the World Health Organization (WHO).
For the past few years, the global public sector and subsidised condom procurement has declined by an average of 30% since its peak in 2011 [Ref: UNAIDS]. This decline has occurred despite Africa’s population increasing by approximately 400 million since 2010, resulting in fewer free or subsidised condoms available per capita today than a decade ago [Ref: UNAIDS]. In Nigeria, the condom gap is estimated to be around 600 million annually. Addressing this shortfall requires a multi-sectoral approach, involving the public sector, media, social marketing, and commercial partners to ensure sustainable condom promotion, particularly among high-risk populations in areas with high HIV burden.
A nationwide survey conducted by AHF Nigeria, in collaboration with NOIPolls and the National Agency for the Control of AIDS (NACA), revealed that 92% of adult Nigerians are aware of condoms and their purpose. While awareness is high, attitudes and perceptions vary. The survey found that 63% of Nigerians associate condoms with sexual pleasure, while 45% view them as a sign of promiscuity. Despite this, 82% of respondents indicated that condoms are readily available in their communities, with the South-East region having the highest accessibility at 94%. In contrast, the North-Central and North-West regions reported the lowest access levels at 77% each.
The survey also highlighted that while 83% of Nigerians believe people should use condoms, only 34% reported personal usage. Among those who use condoms, 32% cited family planning and pregnancy prevention as the main reasons. Gender analysis showed that more men (39%) than women (28%) use condoms, and usage was highest among individuals aged 18-35. However, 66% of Nigerians do not use condoms, with 33% of non-users citing religious beliefs as the primary reason. Geographically, the North-West region recorded the highest proportion (78%) of people who do not use condoms. The survey indicated that 58% of respondents want advocacy groups and other stakeholders to address misinformation about condoms and highlight the consequences of non-use. In addition, 61% of Nigerians believe condoms should be provided for free, and increased access to free condoms could significantly improve consistent usage nationwide.
Condom awareness exists, but usage remains low, particularly in areas with limited access. Advocacy, reduced taxes, and increased investment in supply and education are essential to prevent rising HIV infections and other health risks. Beyond availability, efforts must focus on dispelling myths and promoting condoms as effective protection. Collaboration between the government, private sector, and health organisations is crucial. Increased funding for free or low-cost condoms and awareness campaigns will drive lasting public health improvements. Strengthening supply chains and education can also make a significant impact.
On our part, AHF Nigeria remains committed to working with all partners to push for greater investment in condom access. We believe strongly that protecting the future of millions depends on the decisions we make today. So, we are calling on greater investment in procuring and use of condoms. To be clear, this is not just about preventing HIV. It is also about empowering people to make informed choices, safeguarding young people, and ensuring a healthier Nigeria for future generations. Now is the time to act and ensure condoms are available to everyone who needs them.
Dr. Echey Ijezie is AHF Nigeria Country Program Director.