Family planning: No condoms?

Tantri Yuliandini, The Jakarta Post, Jakarta

"Hey, this guy's buying ribbed, colored, lubricated, plaid, spearmint, condoms!!" the rude drugstore guy yelled at the top of his voice to the chagrin of 37-year-old virgin Larry Laffer in Sierra's 1987 computer game Leisure Suit Larry 1: In the Land of the Lounge Lizards. The ultimate horror experience for the condom-consumer.

This was exactly why commercial condoms could now be found on supermarket counters and next to the bubble gums in modern drugstores -- easily available to the public.

It's accessibility and -- thanks to condom social marketing programs promoting low-cost brands -- affordability should make it one of the most popular agent for fertility control and disease prevention, only it isn't.

Statistics from the National Family Planning Board (BKKBN) showed an alarming drop in recent years in the use of condoms among participants of the family planning program in the country.

BKKBN deputy for family planning and reproductive health, Siswanto Agus Wilopo, said that currently only 0.83 percent of family planning participants use condoms, compared to about 6.3 percent in the mid 1980s. In 2002, the number of family planning participants were reported at 25.8 million.

Considering that the number of people with HIV/AIDS in Indonesia currently stands at between 80,000 to 120,000 and growing, according to conservative estimates by the Ministry of Health, this aversion to condom use poses a serious problem.

"Especially since those infected with HIV are not restricted only to those with high-risk sexual activity but also housewives and children," Siswanto said in a discussion here recently.

He said that one of the reasons behind this was the government's lack of concern for popularizing condom in its national family planning program, focusing instead on female contraceptive methods.

The other reason was the present focus on the condom's role in preventing sexually transmitted diseases (STDs) like HIV/AIDS. Television advertisements such as Harry Roesli's Kenakan Kondom, atau Kena (Use Condoms or Catch It) and their heavy implication on disease prophylaxis have caused married couples to be averse to using condoms for contraception.

"We're seeing a social stigma here, married couples don't want to use condoms because of the 'dirty' or 'sex-for-pleasure' connotation, and what it might suggest regarding confidence in their partner's fidelity," Siswanto said.

He said that although condom sales have reportedly gone up to 68 million last year from 28 million in 1996, they were rarely used for family planning purposes.

Moreover, although commercial sex workers often report high levels of condom usage with their paying customers, it is not the case with their regular non-commercial sexual partners or boyfriends.

Pandu Riono from Family Health International's (FHI) Action to Stop AIDS program also acknowledged the ongoing risks for married women who may be exposed to HIV through their husbands' extramarital sexual encounters.

This was the reason behind BKKBN's recent campaign of "protect yourself and protect others", Siswanto said.

"We are campaigning using easy-to-digest slogans, we want men to love their wives by using the condom," he said.

BKKBN is actively promoting the use of condoms for families, trying to open their eyes to the very real dangers of HIV/AIDS, Siswanto said, and in addition also conduct awareness programs for teenagers.

"Teenagers are the families of the future, it is a known fact that some 38 percent of people with HIV/AIDS are below the age of 29 years old, meaning they contracted it in their 20s," he said, explaining that the BKKBN's campaigns for high-risk individuals will continue.

So why are people reluctant to use condoms?

Ramona Sari, head of family planning and reproductive health division of The Indonesian Planned Parenthood Association (PKBI), said most people cite discomfort as their main aversion to condoms.

"Many say condoms inhibit sexual gratification and interfere with intercourse," she said in the discussion.

Which was why so many condoms now come in different shapes, colors and sizes to enhance the sexual experience, Ramona said.

Many also question the condom's effectiveness as a prophylactic, but Siswanto said that even if the condom leaks during intercourse the risk of infection was still so much smaller than when not using one.

"The fact is, there is no 100 percent prevention, but with the right use of condoms you are greatly minimizing the risk," he said.