By Hillary Bainemigisha

CONDOMS are widely recognised as a highly effective method of preventing HIV infection. The Uganda Aids Commission director general, Dr Kihumuro Apuuli, said massive condom distribution played a big part in reducing HIV rates from 15% in the early 1990s to 5% in 200.

Knowledge of condoms is almost universal, with almost 95% of husbands and wives reporting having heard of them, according to a February research of Family Health Surveys in Uganda. However, condoms remain unpopular in marriage. A large majority of respondents (85% husbands; 82% wives) reported that they had never used condoms with their spouse or had used them only at the start of the relationship.

Many people feel that a monogamous sexual relationship, rooted in concrete trust is an insulation against exposure to HIV. But, according to studies by the Uganda AIDS Commission in National Population Based Survey under the Ministry of Health in 2004 to 2005, 42% of new infections were reported among married couples, higher commercial sex (21%) and causal (12%).

Uganda’s case is not isolated. The UN State of the World Population Report, 2004 revealed that this is an increasingly worrying trend in many countries.

The explanation is, of course, infidelity. When it is discovered, it becomes difficult for the couple in marriage to deny each other sex. Many women in particular, cannot negotiate condom use to protect themselves against HIV. Financial dependence, socio-cultural norms, violence, competition, lack of legal backing and fear to lose the husband, are some of the impediments to women’s freedom to negotiate for safe sex.

In the Family Health Surveys study, people associated condoms with lack of trust and illicit sex. Both men and women said asking a partner to use a condom is equivalent to admitting infidelity or accusing the partner of being unfaithful. A few husbands (23%) and wives (35%) have gone for HIV testing and it is reasonable to assume most do not know their HIV status.

In general, wives showed a more positive attitude towards condoms than husbands. This implies possible conflict in condom matters.

Men, therefore, need to be sensitised that a condom is not an intruder in marriage and when a spouse asks for it, it is of mutual benefit to the family. Her concerns must be addressed first and this should always involve routine HIV testing.

See related story by Dr Love under RELATIONSHIPS

Maureen Nakatudde talked to a cross-section of men to find out what they would do.

Michael Bakulu Mpagi, 35
How! I can’t agree! That is automatically out! You can’t use a condom for a year or even three months. If she insists, I get another one or a girlfriend outside. I fear AIDS but no one goes for sex in order to contract the virus.

Fred Watitti, 29, a builder
(Laughing) I cannot accept that. I have only one wife and there is no need to use a condom.

John Bosco Mugabe, 35, teacher
I would discuss it and if she remains adamant, I would agree. Sex with a wife on tension because she fears being infected cannot be good. Peace of mind is important. She would tell me the conditions for using the condom and I would see how to fulfill them.

Vincent Mayambara, 22
I agree, then go for tests to allay her fears. After a negative test, there is no way I will agree to use a condom.

Bernard Tumusimme 30,
self employed
(Laughing) It is impossible. I would tell her to look for another man.

Herbert Mugaga 35, Journalist
I would just break up with her. As a Catholic, I do not believe in condoms as contraceptives. There are other methods. I would rather not have sex with her with a condom than contradict my religion.

Walter Akena, 23, Self-employed
I would first ask her why. Perhaps she knows something I do not know. I would agree to use a condom then go where she got the idea and learn more.

Shem Semambo, Brand Manager of Club beer
My decision will depend on my wife’s reason to ask me to use condoms. For example, if birth control methods that apply to women are not that effective.

Richard Okello, 30, Guard
That is very complicated and impossible because she is my wife. I would divorce her straight away.

Mohammed Wasswa Kasole,
43, driver
She may have a point. What if I am HIV-positive and she is negative? She would survive and take care of our children. If I have doubts about my history, I would agree.