Unprotected sex on the rise as condom use among Kenyan youth drops

Condom usage in the country has remained alarmingly low, hovering below five per cent over the past two decades, according to the data by the Global Health Report.

Despite being a critical tool for preventing sexually transmitted infections (STIs) and unplanned pregnancies, condom use continues to decline, particularly among young people between the ages 15 and 29 years.

Exemplars in Global Health's findings revealed that in recent years, Kenya had witnessed a concerning decline in condom usage, with the rate dropping from four per cent in 2021 to a mere two per cent in 2022.

In 2022 over 400 million condoms were used in the country by different key population groups unlike the previous year that the usage was over over a billion. Of these 400 milion, 112 million were used by people aged 15-49 years, while 3.9 million were used by people aged 50-64 years.

In addition, over 12 million condoms were used by couples using the product as a form of family planning. Other key populations included people living with HIV, transgender people and people who inject drugs used over 265 million, over 1 million and over 5 million condoms respectively.

This dramatic reduction in the use of condoms has raised alarm among health experts, given the crucial role they play in preventing sexually transmitted infections (STIs) and unplanned pregnancies hence, highlighting the urgent need to address this trend and promote safer sexual practices among young people.

According to the World Health Organisation, the target should be 40 condoms per man per year, however, in Kenya, the distribution is 14 condoms per man per year.

This means that the public health campaigns that once promoted safe sex practices appear to be losing their impact, leaving many vulnerable to the consequences of unprotected sex.

Experts have blamed the low usage of unavailable condoms on the heavy taxation of the commodity in a country where free condom programmes are mainly donor-funded. This makes it difficult for many people to afford regular protection.

Kenyans who spoke to Nation. Africa shared a variety of reasons for avoiding condom use, citing factors such as high prices, social stigma, and a perceived reduction in pleasure.

"I grew up in a Christian household where I couldn't talk to my mother about menstruation. The story of how I survived my first period is a story for another day. So how could I talk about condoms and sex? I didn't have any sex education with my parents," says 24-year-old June*, chuckling.

So she learned about sex from her peers, colleagues and social media. She said she uses condoms with a "friend with benefits" because she does not know how he lives his life outside.

For Jemimah*, her husband hates family planning and leaves her no choice but to use condoms. "When I gave birth to our first child, I used Jadelle for three years as my preferred contraceptive. It destroyed me. I was bleeding every week and it was affecting our sex life. My husband advised me to remove it. I have not used a contraceptive for four years."

We would rather withdraw or use condoms, which has never been a happy arrangement for me," says the 35-year-old mother of two. While condoms have been proven to be effective in preventing sexually transmitted infections (STIs), the majority of Kenyans don't like to use them. Some would rather use Postinor 2 (P2) than condoms.

"Condoms are uncomfortable. I don't like condoms. They make me itch down there. I use pull-outs instead. Unless it's really necessary, like being intimate with someone whose status I'm not sure about, I wouldn't risk it," said Jane*, who is not married.

A spot check of online drug stores shows that condom prices range from Sh100 to Sh1,500 for a pack of three and up to Sh2,000 for a pack of 24, depending on the brand and flavour, making it difficult to afford regular protection.

Similarly, the female condom, also known as the Femidom, is still struggling to gain popularity in Kenya, almost 30 years after it was introduced in the country. The price of this contraceptive can be as high as Sh200 each, making it prohibitively expensive for sexually active and unmarried women.

 According to Bosco Lang'at, a provider of HIV testing services at Goodwill Hospital, a lack of awareness about the availability of the commodity is hampering its uptake.

"Apart from its high cost, the complexity of using the female condom makes it difficult for those who are supposed to use it. Most people, especially young Turks, do not have the patience to wait an extra 15 minutes before having sex. They also say it's uncomfortable to wear," says Mr Lang'at.

According to the Kenya Demographic Health Survey (KDHS 2022), 19 per cent of women had sex with a person who was not their husband or living with them, and only 37 per cent of these women reported using a condom the last time they had sex with such a partner.

 Mr Alex Ojiambo, a health worker in Nairobi, says that misconceptions also play a significant role in slowing the uptake of condoms, especially the Femidom.

"The problem started when people started saying that using condoms reduces sexual pleasure. I have met men who prefer not to use condoms because they believe it affects their pleasure. As a result, many of them resort to the withdrawal method, which can lead to unplanned pregnancies. However, it's important to note that this belief has not been scientifically proven," he noted.

 Condoms are made from materials such as latex, polyurethane and lambskin. People who are allergic to latex should use non-latex condoms. Another misconception about condoms is that they only prevent pregnancy.

When used consistently and correctly, condoms are highly effective in preventing sexually transmitted diseases (STDs) such as herpes simplex virus. They can also reduce the transmission of HIV by 71 to 80 percent.

When used correctly, condoms are about 98 percent effective at preventing pregnancy, according to research from the Cleveland Clinic.

Researchers have expressed concern that public health officials have overlooked condoms in favour of promoting pre-exposure prophylaxis (PrEP), a drug regimen to prevent HIV.

Despite the alarming rise in gonorrhoea infections, young people are less likely to use condoms during sex. However, the Exemplars in Global Health report shows an increase in the use of implants and injectables.

The percentage of married women using modern contraceptives has risen steadily over time, from 32 per cent in 2003 to 57 per cent in 2022.

Modern methods include among others female sterilisation, male sterilisation, IUD, injectables, implants, pills, male condoms, female condoms, emergency contraception, Standard Days Method (SDM), and Lactational Amenorrhoea Method (LAM).

The Constitution of Kenya, 2010, the Health Act, 2017 and Sustainable Development Goal (SDG) indicator 3.7 have enshrined the right of every woman to safe, effective, affordable and acceptable contraceptive services. Kenya's focus is on increasing access to acceptable, affordable and equitable quality contraceptive services to ensure the achievement of zero unmet needs.

The World Health Organization (WHO) has warned of an "alarming decline" in condom use among adolescents, which is expected to lead to a long list of consequences, including higher STI rates and increased healthcare costs.

A recent study in Europe found that almost a third of 15-year-olds (30 per cent) said they had not used a condom or the pill the last time they were sexually active.

 lowoko