Investigation: New Study Reveals Condoms in Uganda Contains WHO Outlawed Nonoxynol-9

Investigation: New Study Reveals Condoms in Uganda Contains WHO Outlawed Nonoxynol-9

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By Patrick Jaramogi

KAMPALA, Uganda: Lover’s Day, or call it Valentine’s Day is coming just a few days from now. Those not in the know, the day is celebrated every 14th of February annually.

That may not be the issue we are highlighting today, but the fact that Valentine’s day is considered a day for lover’s merry making, binge drinking, eating and at times often accompanied by sex. Majority will say, after all, I will use a condom. And this is where we derive our focus today. Reports gathered by SpyUganda, that seems not so good for the condom lovers is that all may not be well with the condoms under supply in Uganda. Recent scientific study has shown that condoms and over the counter contraceptives that contain spermicide nonoxynol-9 do not protect against infection with HIV, the virus that causes AIDS, or other sexually transmitted diseases (STDs). The study, which we have conclusively read indicates that the use of vaginal contraceptives that contain nonoxynol-9 does increase vaginal irritation, which may increase the risk of transmitting HIV and other STDs. The worry is that despite warning against the use of such condoms by the World Health Organisation, some years ago, they are in-fact still abundant in Uganda, majority distributed free of charged in hotels, guest houses, lodges and public offices. Recent studies, including a four-year World Health Organization study of 991 HIV-negative sex workers in Thailand and Africa, showed that nonoxynol-9 does not prevent the transmission of HIV. On June 25, 2002 (17 years ago) the World Health Organization published a 27-page report summarizing what is known about nonoxynol-9 (N-9) — the failed microbicide that actually increases risk of HIV transmission. They concluded that N-9 should never be used for preventing HIV transmission, has no value in preventing other sexually transmitted diseases, and should never be used rectally, where the problem may be much worse than with vaginal use. (The report acknowledges that women at low risk of HIV infection may use N-9 occasionally as a moderately effective, female-controlled form of birth control, when better means are not available to them.)

 

condom brands

WHO noted that condoms should not include N-9 for any use. However, if the only condom available has N-9, it is better than no condom. On May 10, 2002 the U.S. Centers for Disease Control and Prevention updated its Guidelines for the Treatment of Sexually Transmitted Diseases (PDF), also warning against using N-9 for STD prevention. According to the research findings, the spermicide works by damaging the cell membrane of the sperms, and laboratory studies suggests that it may also damage the cells of other organisms, bacteria, and viruses that cause STDs. Based on this data, studies indicate that this membrane-damaging effect can harm the lining of the vagina and cervix, thus increasing the risk of STD transmission and infection. Studies have also shown that Penetrative sex without lubrication leads to increased friction, which puts extra strain on the condom.

Why  Condoms in Uganda  Are Causing Worry

N-9 kills HIV in the laboratory. But it also causes irritation in the vagina or rectum that can allow HIV to infect. A major clinical trial in women, reported recently at the International AIDS Conference in Durban, South Africa, studied over 800 sex workers randomly given either an N-9 or placebo gel, and found 48% more new HIV infections among those using N-9. No one has done such a study with rectal use. But in both humans and animals the irritation is worse, with “sloughing of sheets of epithelium.” The damage is later repaired, but by then HIV could have been transmitted. A survey conducted in Fort Portal, Kasese, Kabale, Ntungamo, Mbarara, Mbale, Jinja, Tororo, Soroti, Gulu, Lira and Arua by our team found that over 80% of condoms sold or distributed free of charge in Uganda are lubricated with Nonoxynol-9. Manufacturers of condoms and lube have no incentive to include N-9, except for this mistaken public demand; and all of these manufacturers also market parallel versions of their products without N-9. Now that there is a clear, official consensus that N-9 is harmful, especially for rectal use, it is likely to start disappearing from condoms and lubes, but when will this happen in Uganda. The community will need to help get the word out, since no one has a commercial incentive to do so, and government agencies are reluctant to speak about this issue, calling it a ‘hot potato’.

What Health Ministry Says

Top Ministry of Health Officials who spoke to us in confidence noted  that much as condoms use in HIV/AIDS infection prevention ranks top in Uganda, the current huge volumes of condoms imported into the country fall below required capacity and WHO accepted standards. Statistics from MOH show that Uganda imported over 400 million of condoms in 2018, though the demand is estimated at close to 600 million annually. Over the years the figures for condom import has been on the rise from 150 million in 2016, to 200 million in 2017 and 460 million in 2018. In 2017, government through the Ministry of Health imported 200 million condoms, which were distributed free of charge to the public. An additional 70 million condoms were imported by the private sector and sold to the public through supermarkets, shops, and pharmacies. Uganda’s HIV prevention strategies includes: pre-exposure and post-exposure prophylaxis, prevention of mother-to-child transmission (PMCT), medical male circumcision, condom use and treatment. Currently, there is an ongoing free medical male circumcision exercise countrywide which according to World Health Organisation, reduces the risk of HIV infection and some sexually transmitted diseases by up to 60 per cent. The Health ministry is also treating all pregnant and breastfeeding women living with HIV with three Antiretroviral (ARVs) drugs combined in one pill, starting early in pregnancy and taking them for life under a treatment commonly known as option B+. This eliminates mother-to-child transmission. When contacted the Permanent Secretary Ministry of Health, Dr. Diana Atwine declined to comment, and referred us to National Drug Authority (NDA) who remained cagey and declined to comment. Similary Health minister, Dr, Ruth Jane Aceng, whom we established is behind the promotion and  imports of the condoms in Uganda ignored our calls and queries. Aceng has been saying more people have embraced the use of condoms, which has reduced the Aids prevalence rate from 7.3 per cent from 6 per cent.

Condom Brands In Uganda

Our findings in the field has shown that there are around 20 brands of condoms in Uganda. But top on the pack is Protector, Life Guard and Trust that are widely used. These go for between shs1500- 2000 per pack of three. Leading supermarkets however have high end condoms like Rough Rider, O Condom, Durex, that go for between shs6000- 18,000 The fact though is that most social, public, and leading government offices that we visited had male condoms placed in the lavatories. But, health experts said that placing condoms in the right venues without a clear message on their use would be counterproductive. The condom campaigns are hurt by the lack of support and mixed messages sent out by, especially, the political leadership. According to the Ministry of Health’s condom programme coordinator, much as Uganda requires some 400 million condoms annually, the public sector procures just half that.. Condom use still remains erratic in Uganda, partly because they not on the essential drugs list and therefore, for the public sector, condoms are [supplied] as per available resources from UNFPA [the UN Population Fund] and USAID [the US Agency for International Development] or the Global Fund… This support is given when the resources are available rather than when the country needs condoms. To make matters more complex, the national HIV strategy does not make any provisions for HIV prevention among sex workers and activists say including them would present legal challenges given that same-sex activity and sex work are both illegal in Uganda.

Health Advice

You may think you know all about STIs, but what you don’t know could put you at risk. Take a few minutes and get the facts for a happier, healthier sex life. If you are concerned about your sexual health, discuss with your physician or doctor.

What is STI?

STD stands for Sexually Transmitted Disease. These diseases are sometimes known as Sexually Transmitted Infections (STIs). An STI is any infection that is passed by body fluids during vaginal, anal, or oral sex. These fluids include semen (cum), vaginal fluids (the wetness in the vagina) and blood. A latex condom acts as a barrier to prevent these fluids from being exchanged. But, an STI can also be spread by contact with the skin of the genital or anal area if infection is present. It can also be spread by contact inside of the mouth. If you are sexually active, it is recommended that you are tested early and often for STIs.

The Top 10 Condoms

Durex Condoms

These condoms are specifically designed to prevent premature ejaculation problems. The UK based company is the first brand to develop and use electronic testing for its condoms and also releasing the first anatomically shaped condom. Apart from condoms, Durex also manufactures lubricants and rings.

In 2002, Durex made a major social impact by supporting gender equity program in Brazil named ‘Program H’. Such projects have been later followed up in countries like India as well.

Trojan Condoms

Trojan is one of the bestselling condom brands in the US, manufactured by the Church & Dwight Company. It is also one of the leading brands in the female condom segment, Trojan Her Pleasure Condoms is manufactured using premium quality latex to reduce the risk of STIs and pregnancies. This is one of the few condoms which is designed from a woman’s perspective, which explains it high sales especially in the US and Canada.

Apart from condoms, Trojan also manufactures lubricants and vibrators. One of America’s leading condom brands, there are more than 30 condom varieties offered by Trojan.

Lifestyles SKYN Condoms

One of the first condoms to be made from polyisoprene, Lifestyles Skyn condoms are known for the comfort and natural feeling it provides to the users. Its non-latex material makes the brand highly popular among the sensitive condom users.

Lifestyles is a global leader in the sexual wellness sector comprising of personal lubricants, condom, and related products. Jissbon, Blowtex, Unimil, and Manix, are some of the other highly innovative non-latex condom brands from this company.

Astroglide Lubes

The water-based, petroleum-free condom Astroglide Lubes has consistently been among the top condom brands for a few years now. Astroglide is a California based company excel in manufacturing personal lubricants as well as desensitizing sprays. Astroglide’s products are moisturizing, long lasting, and are known to provide better satisfaction.

Kimono Microthin Condoms

The brand is known for manufacturing condoms using advanced latex engineering FDA and ISO specs. Known to be 38% thinner than the traditional condoms, Kimono has made it to the list of top global condom brands. Manufactured using premium natural latex state-of-art Japanese technology, Kimono condoms are vegan and paraben free.

Beyond Seven Condoms

A product from the Okamoto brand, Beyond Seven condoms, are made from advanced latex called Sheerlon. The Japanese company Okamoto formed after the merging of four companies is today a world leader in latex technology. The number one Japanese condom brand has several users outsideas well.

Trustex Condoms

A product of Line One Labs, Trustex Ribbed and Studded condoms are the newest entrants in the area of “textured condoms”. The California-based company is a strong advocate of safe sex using phthalate-free latex barriers. Rain lubricants and Lixx are the other popular brands from Line One Labs.

Crown Condoms

Another top condom brand from Okamoto is Crown Condoms. Specially designed for highly sensitive users, Crown Condoms is known for their thinness. Just like the other condoms manufactured by Okamoto, Crown also makes use of the Japanese technology to design products which have minimal latex odor.

ONE Pleasure Dome Condoms

A product offering from Ansell, the One Pleasure Dome condoms are known for their comfortable fit, premium silicone lubricant, and reservoir tip.

Am I at risk for STIs?

If you are sexually active you may be at risk for STIs. Remember, when you have sex with someone, you are potentially exposed to STIs that anyone they’ve had sex with before you may have had. If used properly, latex condoms will help to reduce the risk of transmission of HIV infection (AIDS) and many other sexually transmitted diseases. As we head for Valentine’s day, remember the call by WHO to condom manufacturing firms to phase out the nonoxynol-9 condoms is yet to be achieved. The call is for condom makers put “ethics over profit.” “Almost three years after [the CDC] issued a strong letter warning that condoms made using nonoxynol-9 can actually increase the likelihood of HIV transmission, it still remains business as usual — profit over public health — for these condom companies” . WHO has persistently advised condom makers to clearly put labels on condoms containing nonoxynol-9, but this is yet to happen as 90% of condoms in Uganda don’t have labels.

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