Poll Comments - Communication vs. Condoms

This poll was conducted July 4 - Aug 30, 2002:

Programmes that foster open discussion and debate on HIV/AIDS are as important as programmes that distribute condoms.

Do you agree? Disagree? Unsure?

AGREE [top]

"Distributing condoms won't guaranty that they will be used for safe sex (like so many kids in Majority World countries who use them to make footballs). Programmes that foster discussion and reflection combined with distribution of condoms are the most efficient way to bring about change and sustain it." [Australia]

"Information is key to stopping the spread of the epidemic. In particular, people's access to information but also ability to feel comfortable requesting this information is extremely important. Open discussion will lead to a more pragmatic approach to prevention." [ ]

"Absolutely! Knowledge is power... simple as that." [ ]

"Transparency is important for the success of any programme. By open discussion and listening to opposing views, all issues would have been considered in the decisions on how the programme will move forward." [Kathmandu]

"Openness is the starting point from which communities can move towards solutions. True change can only spring from truth and acceptance. With silence there is always something to hide. Unless one breaks the silence, all other measures can only be palliatives or firefighting." [India]

"Absolutely. Condom distribution is just a band aid. It is open discussion and debate that is likely to foster behavior change and reduce high risk behavior." [ ]

"We get information which is useful from these Programmes and also get support with condoms from those who distribute them. This is because sometimes the information we get in this discussions and debates is what we come up with during these discussions, so if we come up with the solution of using a condom to reduce or stop the spread of HIV/AIDS, we will need condoms. So, if the programmes that distribute condoms are not important, where will we get them?" [Botswana]

"Awareness of HIV is 80 percent of the 'cure'." [USA]

"I believe the issue should have been phrased thus: "Programmes that distribute condoms are as important as programmes that foster open discussion and debate on HIV/AIDS" You certainly cannot build without first of all laying a foundation. I believe that having open discussions and debates on HIV/AIDS in the first place is a means of creating awareness for HIV/AIDS issues which includes discussions on methods of prevention, mode of infection, symptoms etc. Therefore on what will programmes for distribution of Condoms be anchored if there is no awareness for HIV/AIDS as a main issue? There is no doubt that Programmes promoting open discussion on HIV/AIDS will also focus on the use of condoms as a preventive measure." [Nigeria]

"Condoms are a stop-gap measure. Prevention is most effective and prevention depends on knowledge received and acted upon. Debate and discussion air out issues concerning AIDS/HIV. Whether or not true consultation results is dependent upon the will of those involved in the discussion. If a confrontational attitude underlies expressions of opinion, then all we get is another form of conflict. If, however, the object is to gain effective ways to combat the spread of AIDS/HIV and open minds are brought to discussion, then progress is possible. Again, progress is dependent on human will. Is the campaign serious business, or is it self-promotion of one's own ideas?" [Canada]

"In order for condoms to be effectively and consistently used, there must be an understanding of how condom use helps in the prevention of HIV/AIDS. People need to know what HIV/AIDS is, how it is transmitted, and ways in which THEY can protect themselves from contracting the disease. POSITIVE public discussion and debate about HIV/AIDS helps to dispel myths and misconceptions about the disease, and the people who are living with it directly or indirectly. Discussion and debate are absolutely necessary to promote behaviors that reduce risk of infection (e.g., condom use), lessen stigma and discrimination, and mobilize communities to take action to stem the tide of the epidemic." [ ]

"They are obviously more important. Condoms are the "too-late" type of response and we know that many people will not even use them because they are not yet well aware about the real risks of contractic HIV-AIDS. Curative measures or preventive measures that do not involve awareness creation through a participatory approach, are useless. They only help while funds for it are available. They do not create any sustainable response. They do not take into consideration cultural specificity: just one standard response for the whole world. No wonder that things are getting worst in spite of all the money invested in the last 20 years. Much more than for any other disease." [Guatemala]

"It is more important. Distributing condoms without any discussion is like inserting a leaflet in the pages of newspaper which nobody bothers to go through. Open discussion will create a willing demand for the condoms." [India]

"Not wise to discuss about aids without giving the right to protection to people." [Rwanda]

"Basic things are as or more important that global strategies." [Colombia]

"The two must not be distinct from each other. Programmes must be integrated. There will be far less impact if a programme's activity is solely to distribute condoms without activities that also foster open discussion and debate, running alongside this. Similarly people must have access to condoms if discussion and debate is realistically going to lead to change." [ ]

"Before any people could agree to use or not to use condom, they must first discuss the option and the risk of not using protective devices. Discussion and concessions must first be arrived at before condom. Therefore fostering discussion on condom is a pre-requisite for adequate appreciation of the value of condom use." [Kenya]

"I definitely think they are at least as important if not more so, as I am aware of several situations where it is the social and community attitudes that have been the most vicious reaction that people living with aids and their families have had to deal with." [Sri Lanka]

"Agree -- IF the open discussion leads to more condoms being distributed (and used) and a number of other changes as well." [ ]

"There does not seem to be a convincing correlation between condom use and HIV-AIDS prevalence thus indicating that there are many other behaviours that influence prevention." [USA]

"The reason for my agreement is that when we make open decisions on issues than shelving them turn to hurt society. The menace of AIDS is such that people whould be made aware of it before it causes more harm than good." [Ghana]

"I have made a personal commitment to encourage just such a response." [Australia/India]

"If people have a better understanding of how HIV is transmitted there will be changed behavior and increased use of condoms." [ ]

"Agree, at least until people at risk are using condoms." [USA]

"Though condom is one of the solutions for preventing HIV/AIDS disimination, It is not the ethical one both from the religious and cultural grounds of most of the communities. Particularly the largest religious groups, christians and muslims. Besides, what is killing sub saharan Africa now is the impacts and effects of the pandemic. In this regard the importance of programs which aim at creating a fora for breaking the silence attached to the disease, creating a public understanding so as to minimize the stigma & discremination, and sharing valuable experiances in this regard is so much important. We are living in hiv pandemic, aids pandemic is not yet seen." [Ethiopia]

"There are always youmg people coming of "age" who will need to hear the debate and others needing reminding. Condoms are one way of prevention but open discussion can cover and discover them all." [Wales]

"Real profilaxy implies understanding not mechanical acts, as using a condom. The basic is to understand what is put on risk." [Mexico]

"As long as we continue to dialogue we can not lose this war. It is when we stop talking that the battle is over." [USA]

"Taboos kill! Breaking taboos brings things into a calm perspective and allows objective choices to be made. This applies in all cultures - I have seen it in the media for health training I have provided to almost 100 countries." [UK]

"A service is only as good as its purpose is understood and discussion promotes understanding and appreciation of the service." [ ]

"In certain (sub)cultures there is a taboo on being infected with HIV/AIDS. As a taboo means 'no' communication, there will be hardly any information on how to prevent being infected by HIV/AIDS." [The Netherlands]

"The distribution of condoms has consistently been proved to be ineffective if not accompanied with a constructive debate on HIV/AIDS and fora for all groups of society to engage with this debate. It is vital that everyone in any society is able to make a responsible personal risk assessment before they can consider whether or not condoms are the appropriate response for them and then how they will negotiate their use. These kinds of decisions cannot be made without a larger understanding of the impact of HIV/AIDS and usually without the consultation of partners/peers. Beyond this, the issue of HIV/AIDS must not be reduced to an issue of prevention and nothing else. Stigma and discrimination of people living with HIV/AIDS is as important to eradicate in the same way that it is imperative to assess care and support needs of these people and their families and communities both whilst living and after they have died. Open discussion is therefore vital." [Cameroon]

"Verbal communication allows the topic to be at the front of the mind. It will provoke more thoughts and concerns about the risks." [USA]

"Naturally I agree it is important that there should be holistic approach to control and treat HIV/AIDS. So are other issues of development." [Pakistan]

"Though I still feel it is a neccessry evil to prevent infect for though who are already infected.Discussions are important but some people are already infected hence need to be given condoms so that they do not infect other HIV-negative partners." [Malawi]

"Education and discourse are the keys to EVERYTHING." [USA]

"Without such debate condom distribution is much less effective." [Zimbabwe]

"Condoms are often a one-off band-aid solution if not coupled with counselling, debate or other forms of information." [Denmark]

"While condoms address an important part of the campaign against HIV AIDS, they do not address the issue of ignorance and the stigma surrounding HIV AIDS that delays acceptance of the condition and makes HIV positive people hide and delay treatment while continuing to infect or affect others. Education and free discussion of HIV AIDS plays an important role in prevention of new infections as well as better care for the already infected." [UK]

"My agreement indicates that such discussion can encourage normative support for HIV prevention." [ ]

"Condom distribution is essential as a 1st response to combatting HIV/AIDS. In order to ensure sustainability, individuals have to be educated about why it is so crucial to prevent the disease; means of controlling its spread and empowerment issues, particularly for women to enable them to demand safe sex." [ ]

"Communication is education, and is essential to the success of any program. Distributing condoms without the educational component is like distributing parachutes without the jumping lessons." [Canada]

"It's very simple: people won't use condoms unless they understand the need and are convinced of the appropriateness of preventative behavior and safe sex." [ ]

"It would disseminate concern." [India]

"In developing countries where the HIV/AIDS impact is greatest, condoms are not readily available and where they are, people would not want to spend the little money they earn on them. In addition there are many other reasons for not using condoms. This attitude makes the condom program not best means of control. Education and awareness remains the most viable and cost effective means of curtailing the spread of HIV. In combination with latex barriers (distributed without cost to the users) makes an method effort for HIV prevention." [Canada]

"This is true, in Malawi the multimedia HIV/AIDS public health campaign has achieved high levels of nationawide awareness but this has been slow or done very little to be translated into health behavioural change that is very effective HIV/AIDS control and prevention. During my research fieldwork meetings with communities, parents and teachers I realised that one of the things that this public awareness has done is to create alot of questions and issues in the minds of the people that they would have wished to discuss with the experts or their friends. I could tell this by the number of questions I recieved from the audience and request for more meetings similar to the ones I was holding in future because it assists them to ask things they would have wished clarifications. I therefore learn't that until people are sure of their positions and positions they want to change to, they will not change their sexual behaviour and sexual practices in particular in cultures where sex is a taboo. This was the same with the youths I had talked to in schools." [Great Britain]

"People neeed a reason to use a condom, and discussions provide reasons for people to use condoms." [ ]

"Education and information are preliminary steps to any change in behavior. Following up with tools for prevention results in greater participation." [USA]

"Open discussion on delicate matters is rare in Africa. Knowledge of AIDS/HIV will perhaps help to reverse the awful march of the disease. [UK/Senegal]

"Education as well as condoms are necessary in order to enhance safer sex habits." [ ]

"Information is a powerful tool. Debate and discussion play a mojor role in bridging the information gap as well as provide insights into the real situation and foster possible attitude change in the discussants as well as the listeners." [Kenya]

"Condoms won't be used (even if they are distributed) until people talk in order to reduce stigma and openly discuss the importance of condom use. The distribution of condoms is obsolete without the social context needed to support their use." [USA]br>

"Without broad public awareness and concern, distribution of condoms is ineffective. The same goes for the availability of anti-AIDs drugs. Activists urging expenditure of tens of millions on drugs should not overlook the need to link availability to adequate service delivery, monitoring and public education." [Canada]

"Education and awareness are as important as prevention measures for sustained behaviour change." [ ]

"This is because open debates on HIV/AIDS would inevitably include discussion on alternative preventive measures and condom use is one of them. People would clear their questions about the condom and other related misconceptions. The outcome of open debates would be critical awareness creation that would lead to change in behavior including use of condoms." [Malawi]

"Discussion will clarify doubts, bring about conviction." [India]

"Education and awareness might lead to the wider use of condoms." [UK/Senegal]

"Without open discussion, in Africa, condoms are useless." [ ]

"The affected know the roots of development problems and might even have the best solutions for those problems." [Malawi]

"The world has to be reminded that HIV/AIDS is not a natural disease but kindled out of man's tinkering with nature. The global spread of this terrible disease should be a warning to all who would tamper with nature and experiment on the world's poorest nations. Western thinking has managed to dismissed the disease as one caught only by "irresponsible" people. This is a neat "cop out" of responibility for those who created and spread the disease in the first place." [England]

"Condoms won't be used, if people are not encouraged and ready to discuss issues on sexuality, sexual relationships and the impact of HIV/AIDS on all segments of private and public life. Years of condom promotion and access to condoms did not increase condom use as expected. Condoms are not the key to (sexual) behaviour change. If the society and politicians do not allow and promote open debates, condoms won't be a solution either." [ ]

"yes, absolutely HIV/AIDs must be discussed and not just among the important "at risk" groups of IDUs, sexworkers and migrant employees! Government officials in SE Asia are not well-informed about basic procedures of surveillance testing, blood safety, or Voluntary Counseling and Testing nor on the ethics/seriousness of a positive diagnosis. For many people the attitude is still "us and them" or it can't happen to me or my family. Ignorance is never a protection. If treatment is not available for HIV positive patients, clear public dialogue will be the only stimulus for hope to those patients and their families to seek care anonymously but with compassionate services provided by publicly funded clinics as well as other agencies. No talk, no action." [ ]

"An analysis reported in the articles below found that the knowledge that others in the community are using condoms increase own condom use. Also the knowledge of prevalence of HIV/AIDS in ones community increases chances of condom use. Thus, it only through open debate that people can be educated. Actually, distribution of condoms does not imply use. Kirigia, J.M. and Muthuri, L.H.K. (1999). Predictors of women's decision to ask new partners to use condoms to avoid HIV/AIDS in South Africa. East African Medical Journal, 76(9): 484-489 Kirigia, J.M. and Sayed, R. (1998). Predictors of condom use in the prevention of HIV/AIDS in South Africa. African Journal of Health Sciences, 5(3-4): 178-184." [Congo]

"Debates and discussions raise critical awareness in communities that are directly effected by Diseases such as HIV/AIDS. This is to say that everyone needs to know, be convinced and then start acting out of a real behavior that he have aqired through this process. Distributing Condoms should coincides with debates and discussion sessions with concentration on the later." [Egypt]

"They are both equally important. Information and debate fosters comfort with and confidence about discussing issues of sexuality, an often highly emotionally charged issue. Access to condoms as well as knowing where to get them and how to use them are equally critical." [USA]

"Just handing out condoms is not enough. There are many other ways that you may acquire HIV such as crack cocaine smokers have burns and open suts on their lips from the crack pipe and they pass the pipe around to others. Also, what leads to risky behaviors? Many things such as peer pressure, low self-esteem, fatalistic views, poverty, etc. We need to address all of these with the public in order to make a dent in the fight against HIV." [USA]

"Open discussiion of HIV/AIDS is critical to eliminating the stigma that surrounds AIDS. It is only by lessening the stigma that we can truly begin to deal with the consequences of the epidemic." [ ]

"Nearly 85% of HIV transmission is occuring through sexual route and use of condoms is the most effective and safe method of intervention to prevent transmission.Moreover ignorance about the efficacy of condom in preventing HIV transmission,lack of positive attitude towards the use of condom, it's availability(of quality condoms), accessibility,proper utilization and mis-utilization needs to be tackled." [India]

"I agree but I think the both elements can be complementary (forums, information, prevention campaigns concerning HIV/AIDS and distribution of condoms)." [France]

"It has immense impact in the society as a whole" [Bangladesh]

"This is important especially in countries where talkin about sex is not culturally acceptable. Under the circumstances, just distributing condoms without talking about its benefits for a better reproductive life is not complementary." [ ]

"In most third world countries where the epidemic hits hardest, denial and silence remain major problems. I have worked in HIV/AIDS for seven years in Nigeria and do know from field experience that most communities have been unable to speak up. By speaking up, the epidemic is placed on the agenda of discourse, arousing community interest and ultimately fostering decision making. Infact programs that foster open discussion and debate will compliment condom programming. In communities where you have open discussion, the condom is hardly stigmatized and people are not ashamed to purchase and use the condom. To stem the tide of the epidemic, open discussion interventions should go side by side with condom programming. One is not more important than the other." [United States]

"There exists a stigma around AIDS today that cannot be ignored. Open discussions may assist in getting rid of such feelings that are hindering the canarge that is HIV/AIDS, especially in Africa." [Kenya]

"We need to know AIDS for no AIDS." [Bangladesh]

"Such programs do complement the effort for people who are at high risk of contracting the virus. Again it is important for people to be open to listen up and do according to correct guidelines on transmission and preventative efforts. It's not in vain to pass messages in open fora. It even helps dilute the issue of stigma." [Kenya]

"In real sense the distribution of condoms is even irrelevant without HIV/AIDs discussions and debates. In my own opinion the debates and discussions are even more essentail. See the case of Uganda." [Uganda]

"Open HIV/AIDS discussions cannot be divorced from condoms. When discussing about HIV/AIDS condoms are mentioned as a way of reducing transmission at the same time when condoms are distributed there is mention of dual effect that condoms offer pregnancy prevention and reduction in the spread of STI's including HIV/AIDS. The two are twin programmes and as such are equally important." [ ]

"Open discussion on HIV/AIDS can also lead to more and consistant use of condomes as well and can increase its usage." [Papua New Guinea]

"Necesitamos modificar creencias y actitudes de la gente para favorecer el uso de condones y el autocuidado y el cuidado del otro previo al reparto de condones. - TRANSLATION HERE." [Argentina]

"Open discussions reveal just how ignorant people are on the subject of HIV/AIDs. Many do not even know how to use the condom successfully. Open discussions sure help." [ ]

"Open discussion on AIDS/HIV and on sexuality are very important - particularly among adolescents and young adults. While distributing condoms is important, it cannot work as well as giving young people the power of knowledge." [India]

"I agree because the two should in effect compliment each other, for example a programme that fosters open discussion on HIV/AIDS should naturally lead to discussion on the prevention options that are available to an individual, in this instance the relevancy of condom distribution then comes into perspective and should provide an individual with enough information to make an informed choice irrespect of religious and other contrary teachings." [Kenya]

"Fostering an open discussion on HIV/AIDS is a prerequisite to the distribution of HIV/AIDS. Before people could accept to use condom and to purchase condoms openly, it must first be ingrained in them the indispensibility of condom in the prevention againsts HIV/AIDS. And HIV/AIDS must have had prior open acceptable discussion before condom could be acceptable. Over 90 per cent of the Kenyan for example are aware of HIV/AIDS, however only 33 per cent of them uses a condoms with a new sexual partner. Reason: Awareness cannot be equated to an open discussion of HIV/AIDS. Fostering an open discussion on HIV/AIDS increases the knowledge and accetance leading to desired behaviour change, whereas awareness may not necessarily led to the same as has been proved. Otherwise, fostering open discussion and debate on HIV/AIDS are more of a prerequisite for all other interventions designed to combat HIV/AIDS." [Kenya]

"Absolutely, since many of the obstacles to safer sex are complex and social in nature. However, availability of condoms and prevention services, like testing, are also essential if the the discussion is to lead to action." [ ]

"Open discussion is important because it fosters a greater understanding of the issues involved in HIV/AIDS." [Australia]

"There is an urgent need to break all taboos regarding this and other sexual and reproductive health issues. Especially those fueled by shortsighted religions that can't see beyond their noses and don't want to face reality. It is true that abstinence is a powerful way to prevent HIV. But there will always be people who will not respond to those messages. That is what make us human. I think it's totaly absurd to believe that talking to youngters about sex and condoms will just motivate them to seek more sex. It is all in the way you deliver the message. But too many parents are cowardly ingnoring their children cry for help. So these young people have to look for answers anywhere they can find them need to acknowledge also the other ways." [USA]

"HIV/AIDS update is known only to a few persons who are affected or involved for the cause. Knowledge in the primary key to prevention and spread in the community." [India]

"Condom distribution is one of the many methods to reduce spread of HIV/AIDS." [ ]

"The war against HIV/AIDS is about opening spaces for discussion. The condom (male and female) and debates on HIV/AIDS is about opening spaces for discussion." [South Africa]

"I agree only so long as "...are as important as..." includes ... are more important than..."" [UK]

"One story told by a cousin who worked in India as an extension worker may prove my sentiment right. My cousin was distributing condoms to hinterland villagers in India. Trying to demonstrate the use of condom, he took a twig from a standing tree and inserted the condom onto it. "This is how to use the condom to prevent HIV/AIDS transmission, he said in the native dialect. He went home feeling quite alright about his demonstration. The next time he visited the community to check on the progress made, he was more than surprised. - Condoms of all colors decorated the twigs of the tree where he plucked a twig for the demonstration!" [Philippines]

"It seems that stigma is still a huge problem in implementing any type of program, so dialogue is very important." [US]

"It is a problem that needs to be brought out into the open and also awareness and prevention information should be shared as widely as possible." [USA]

"Both are important aspects of the same coin. Increasing demand through open discussion of issues of sexuality may motivate people to use condoms. Where they are not available, the program is likely to lose confidence of the target audience." [ ]

"Education and application are necessary at one and the same time for successful treatment." [USA]

"As long as before distribution, a lecture to demonstrate how to put on and take off a condom is performed by a local health worker, and after the demonstration, condoms are distributed with small pocket sized leaflets re: STD/condom wear." [UK]

"Condom distribution is only one part of all the things people have to know and understand for being able to deal with HIV/AIDS. It is the same as for playing cards, you need all the cards, if not the game does not make any sense." [ ]

"Such fora ceates a platform for interaction ,create awareness on scourge of aids and dangers.knowledge is power a man better informed about aids will not need to be educated on the use of condom." [Nigeria]

"We can't stop people from having sex, so might as well inform them in having safe sex." [USA]

"HIV/AIDS remains a Social Illness since it is contracted from Social life, Sexual Intercourse. It is an Illness similar to sustaining an irreparable injury in a football match that must lead to death. So, like sports, games, needs to be discused in forums, gatherings and in public places so as to contribute to the Economic Development of Nations." [Camaroon]

"I do believe open discussion is the best way of education." [Ghana]

"Including the HIV pos. is equally important to prevention." [ ]

DISAGREE [top]

"More important because the distribution of condoms alone does not necessarily guarantee they will be used. Open discussion and debate however is one way of making sure that condoms are put in use and therefore more important than condom distribution." [ ]

"While availability of condoms is a major factor in HIV prevention, I don't see evidence where making them extremely cheap or even free would significantly increase use. Cost is not a factor, for instance, for women whose husbands cheat with sex workers. She has other, stronger barriers to use condoms. It seems to me however that most programmes that distribute condoms are also engaged in fostering a debate in HIV/AIDS and in that sense the dilemma proposed by the question is not a real dilemma." [USA]

"I believe that programs that foster open discussion and debate are more important: it is through such action that we succeed in convincing people to use a condom, to abstain, to limit partners -- breaking down barriers to perception of risk." [ ]

"Dialogue on HIV/AIDS has the potential to create social learning environments where individuals can gain awareness, understanding, self reflect and be motivated to modify their behavior. Distribution of condoms may not have such positive potential." [USA]

"Given the fatalist attitude of the average Indian, a programme without an intervention strategy has less of an impact than one that has." [India]

"Building awareness is main factor but distributing of condoms is encouraging of illegal sex and it will spread out." [Bangladesh]

"For condoms to be used effectively amongst partners there must be open discussion." [Malawi]

"Distribution of condoms per se does not foster sex behavioral change: it must always go hand in hand with sensitization programes." [Uganda]

"I believe that emphasis on distributing condoms at the expense of behavioural change and by that I mean refraining from sex is a fundamental mistake. The implicit message is that you can do what ever you want but just use a condom. The HIV/AIDS programme needs to address more fundamental human psyche issues and not just putting a band aid on a festering sore and the Condom programme is doing." [South Africa]

"Condom distribution encourages random/illegal sex without regards to God's purpose for sex." [Liberia]

"Both are important. The condoms distribution don´t change sexual behaviors." [Peru]

"Programmes that foster open discussion and debate on HIV/AIDS are MORE important than programmes that distribute condoms. Condoms are not 100% and most importantly, without the discusssions and debate, they will not be used 100% of the time nor used correctly. Discussion and debate also get people who do not think condoms are for them to consider using condoms. The distribution of condoms alone is ineffective. It must be preceeded by and accompanied by open debate and discussion." [ ]

"Discussion and debate about HIV/AIDS is more important than programmes that distribute condoms." [ ]

"The programmes are more important because they are more bound to lead to behavioural change than condoms distributed. With the distribution of condoms one may not be quite sure whether they are being used at all or they are beng correctly used." [Uganda]

"I can know the importance of HIV, but if I don't have access to condoms, than this information will be almost useless to me since I know I'm going to have to have sex with my husband tonight." [ ]

UNSURE [top]

"One tends to get seriously despondent when faced with an increasing number of educated and 'liberated' people who know all the facts and have access to all the condoms they need and who still choose to play russian roulette. Is the message of HIV/AIDS getting through? Or do we just wait for it to peak and eventually burn out?" [Zimbabwe]