Abstract
The prevalence of HIV in Lesotho is among the highest in the world, with almost one-quarter of the adult population infected. Although large-scale HIV prevention efforts have resulted in a 16% decrease in new infections, risky sexual behavior and insufficient levels of condom use continue to drive the HIV epidemic. Male condoms are a vital part of Lesotho’s HIV prevention strategy, and because condoms offer dual protection against both HIV and unplanned pregnancy, they also play an important role in meeting the need for family planning.
In Lesotho, the number of condoms needed to protect all sexual acts from HIV infection and unplanned pregnancy (universe of need) is much higher than the actual number of condoms on the market (volume). However, public health efforts encouraging condom use for HIV prevention and family planning have resulted in some very positive trends. Demand for condoms has increased over the years, including among those with higher risk behavior. In 2012, 61% of men and 46% of women reported using a condom the last time they had sex, more than double the percentage in 2004 and more than 25% higher than in 2009. Equity in condom use has also improved. According to recent data, approximately one-third of condom users fall into the bottom two wealth quintiles.