Not many people consider condoms a family planning method. In fact, many will tell you that a spouse in possession of condoms is an unfaithful one. Others just will not hear of it, arguing that condoms interfere with intimacy, writes Carol Natukunda.

Sex with a condom? But you are married!” This is the reaction a friend got recently, when she confided to peers that she and her hubby use condoms to space their children. There is an assumption that when you ask for condoms, you are having sex elsewhere other than in your marriage. Asking for a condom breaks the supposed trust and intimacy.

“They’re good for the time when you’re still thinking, “I don’t know her too well, or where she’s been. But after marriage? C’mon! It spoils things,” says James, a married father of two.

Despite its controversy, the condom is increasingly becoming a popular family planning method among marrieds, according to the 2011 Uganda Health Demographic.

The survey, conducted by the Uganda Bureau of Statistics showed that whereas Ugandan married women generally prefer the injectables, the condom is also used, especially among married women in urban areas. About 4.35% married women in the central region had used the male condom as a contraceptive method in the last one year compared to only 0.9% in the rural areas such as Karamoja.

Kampala, being a cosmopolitan city was categorised separately and it had the highest number of married women (4.7%) using the male condom to space their children.

Information about use of contraceptive methods was collected from over 8,000 female respondents by asking if they (or their partner) were currently using any method. In general, women did not begin to use contraception until they had at least one child.

Sex is sex

Edith Karugaba, a 40-year-old mother admits that she prefers non-condom sex which “we did when trying to get pregnant and while pregnant”. But she doesn’t find condoms too much of a hassle. “I don’t understand how using a condom is ‘lack of intimacy.’ He’s having sex with you, how much more intimate can you get?”

Some married couples use condoms because of their strong sensitivity to various issues, from hormones to the sexually transmitted diseases. Karugaba explains that not only do other birth control methods wreak havoc on her body — weight gain and migraines — but she is also guarding against an unwanted pregnancy.

“I cannot take birth control pills because they can’t protect me like the condom does. I have two children and I am done giving birth. The hormonal methods sometimes don’t work; the condom, it is rare. If it broke, I would swallow the emergency pill. Besides, if my hubby went astray, that will be up to him. Men these days are funny. He might bring you HIV,” she reasons.

“I cannot do hormones (pills) at all,” said another mum. “Even the coil was bad.” Experts ’ views

According to a survey by the Uganda Bureau of Statistics, the urban woman is more likely to demand for a condom. “In the urban areas, people are exposed and have knowledge about condom use, so they embrace it as a family planning method. The condom is also more accessible; it is in the pharmacy, in the health centre and more available for someone in Kampala than a person deep in the village,” observes Annet

Reproductive Health Uganda

“An uptown woman has the ability to negotiate for a condom; she is assertive and opens up easily because she knows her choices. On the other hand, the woman in the village is not exposed, and many times, she fears to tell her husband what method they should use. The man dictates on whether or not to use a condom,” says Kyarimpa.

Elioda Tumwesigye, a member of the parliamentary committee on HIV/AIDS, concurs and points out that the use of the condom increases with level of education.

“In places like Kampala, we have more literate people. They have read and are informed. In villages where most people are not educated, there is stigma about the condom. They associate it with HIV, not a family planning method. The town has so many people and if someone is not sure (of their status), they use the condom,” says Tumwesigye.

He says if the couple has tested and they trust each other and are faithful to one another, then condoms in marriage cease to be about ‘cheating’ and starts being about “we don’t want a baby now.”

Reports show that the HIV prevalence rate has shot up from 6.5% to 7.3% with most of the infections among marrieds aged 30 to 40. When used consistently and correctly, the male condom is effective for the reduction of sexual transmission of HIV and of other sexually transmitted infections.