Manya Andrews is a health communications consultant and former head of the international reproductive health organization, Populations Services International, in Togo. At a recent conference on HIV and couples, she spoke to IRIN/PlusNews about how she and her team had to rethink what they knew about sex to kick-start Togo's male condom distribution campaign.
"We'd reached a plateau in condom distribution and we went back and looked at the product. We were transitioning from one donor to another, so there was an opportunity to change [condom] suppliers ... we decided it was a real opportunity to find out what people liked and what they didn't like.
"The top three complaints were the smell, which was pretty strong, the fact that they broke all the time, and the fact that they were not lubricated enough.
"Basically, the condoms we'd been ... [distributing] had the thickness and sensitivity of a tyre, the ... [lubricant] was, like, this corn-starchy stuff that smelled awful, [and women said] they were painful. They were just all wrong, so we started testing other [condoms]. After we switched we had a spike in uptake.
"We were also surprised that people wanted to use condoms. Even our own staff ... [had] this misconception that people didn't want to use condoms, and sometimes we were basing decisions on this.
"We had this funny experience where we had auditors from the Global Fund [to Fight AIDS, Tuberculosis and Malaria] come in while we were testing these new condoms.
"We had condoms all over the tables in our board room and were smelling them, touching them, tasting them ... and these guys from PricewaterhouseCoopers [the auditing firm] walked in.
"We [also] had people being coached on [how to use a condom] but what we found was that they still needed to get it into their hands and to work on it and try it themselves.
"It was another huge lesson learned for us and so we suddenly said, 'We need to totally change the way we are doing this.' We needed to get off the podium and get into the crowd.
"No wonder people will tell you it takes too long to use a condom – by the time we were done explaining the 15 steps to using a condom [it was] 15 minutes later; people must assume it takes that long to actually use one.
"We said, 'Let's simplify this thing down to two steps – 'pinch' and 'unroll' - that's it ... If I can do it, you can do it, and before we all leave, we're all going to learn how to do it, and we're all going to be 'condom certified.'
"All the outreach now around condoms literally focuses on getting every person to master the skill before they leave the session."
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