Resistance to condom use in Swaziland has proved a perplexing failure for the
government and health NGOs, a failure whose consequence is apparent in new
statistics on the epidemic released by the Joint UN Programme on HIV/AIDS
"We failed to learn the lesson of recent history that condoms are unpopular. We
should have stressed education, abstinence and faithfulness to your partner from
the start," Thabsile Dlamini, secretary of the Swaziland Nurses Association,
The UNAIDS report released last week proved depressing reading. In Swaziland
"the epidemic has assumed devastating proportions", it said. "National HIV
prevalence in Swaziland has matched that found in Botswana, almost 39 percent.
Just a decade earlier, it had stood at 4 percent."
Like Botswana, which has led the world in HIV infections among its adult
population, Swaziland shows no sign of incipient decline in HIV prevalence, the
In the anti-AIDS struggle the focus has increasingly shifted to antiretroviral
drugs, which are beginning to become available in Swaziland. But as treatment
efforts are stepped up, there is concern that prevention programmes are
receiving less attention.
"The emphasis is [on] treating the sick, and lengthening the lives of
HIV-positive persons. This is good, but there is still a need to prevent
infections in the first place," Dlamini said.
Despite the AIDS toll, and the years of safe-sex messaging, condom use remains a
"Swazis dislike condoms. They are unSwazi," declared Nhlavana Maseko, an
influential traditional healer, when the World Health Organisation (WHO) began
distributing condoms in the 1990s.
One of the country's top traditional leaders, Jim Gama, governor of the royal
village Ludzidzini, has also ridiculed condom use as being inconsistent with
Swazi manhood on his popular weekly programme on government radio.
A snap survey of attitudes carried out at the bus rank in Manzini, the central
commercial town and densest population centre in the largely rural kingdom,
found respondents using condoms on occasion, but without consistency or with
faith in their effectiveness.
"I use condoms until I run out, and if they are not available that doesn't stop
me from having sex. Condoms are not 100 percent effective," said Mfanakhona
Khumalo, 23, a bus driver.
Mary Nkambule, 25, a seamstress, was more emphatic. "Condoms are useless," she
said. "They cut down on pleasure. They are like eating a sweet with the wrapper
The founder of the Swaziland AIDS Support Organisation, Hannie Dlamini, caused a
stir this month when he broke from the strategy of Swazi health organisations
that promote condoms, and publicly condemned condoms at a rally of Christian
"Condoms don't stop AIDS. They don't work. Only faithfulness and abstinence stop
AIDS," he declared.
Dlamini's remarks, in which he also said that UN agencies have distributed
millions of defective condoms, and warned that condom users to "do so at their
own risk", were given banner headlines in the Swazi press.
The WHO and UNAIDS responded with newspaper adverts condemning the sensational
reporting, along with "misinformation and disinformation".
"Consistent and correct use of condoms reduces HIV transmission by at least 99
percent in humans. This is not 100 percent, but it is pretty close to it!" said
the WHO and UNAIDS statement.
Thabsile Dlamini of the nurses' association is among health officials who have
observed the failure to popularise consistent condom usage among Swazis, and
feels other curbs on sexual activity must be pursued. "AIDS is a moral issue,
and the churches are now talking about promiscuity and adultery," she said.
But social welfare officials like Esther Kanduza of the Woman's Resource Centre
in Mbabane, feel efforts to promote condoms must persist, in light of the
doubtful alternative of promoting total sexual abstinence. "Swaziland is a
polygamous society where multiple sexual partners are the tradition," she noted.
The WHO and UNAIDS statement agreed: "Abstinence is certainly the most perfect
behaviour to avoid HIV/AIDS, but experience shows that a small percentage of
persons are going to stay abstinent for the remainder of their lives."
The statement concluded on a wistful note, tied to the need to continue a policy
of condom advocacy. "Wouldn't it be nice to think that by completely abstaining,
or by using correctly and consistently a condom, close to 200,000 persons now
living with HIV/AIDS in Swaziland would prevent the infection of those who are
not infected, or [not] re-infect themselves, and lead normal lives?"
Swaziland's current population is approximately 970,000.