•Condom
As the price of condoms skyrockets in Nigeria, medical practitioners and other concerned stakeholders fear that it could lead to low demand and force many people into unsafe sex, which could increase sexually transmitted infections including HIV and a boom in unplanned pregnancies, reports Sunday PUNCH.
Stanley Uba was shocked to the marrow when he picked a pack of condoms off the shelf of a supermarket and saw the affixed price.
Curious, at the same time, dumbfounded, he walked up to the cashier with the pack and stammered in a low tone, “How much; is this now the price?”
The young lady, who was eager to attend to other customers clustering around the pay point, blurted impatiently, “That is the price. Please let me attend to other customers if you are not ready,”
Lost in thought, Uba, who had anticipated getting a soothing and rousing romp with his wife after eating his dinner, walked into the dimly lit street.
Prices of condoms, like other commodities, have experienced a drastic upsurge.
Men patronising commercial sex workers, those with side chicks, couples who have adopted the use of condoms as a family planning method and commercial sex workers have unrelentingly, lamented the astronomical hike in the prices of condoms in Nigeria.
Some of the men, who complained bitterly about the price hike, said though they enjoy having raw sex with their wives, it was risky to go the same route with strangers without using condoms.
According to them, the prices of different brands of condoms needed during sex to stop the transmission of infections and protect against unplanned pregnancies have increased by over 300 per cent.
“I never knew that things would be so hard in Nigeria today to the point of condoms becoming too expensive to purchase. A pack of Durex Extra Safe condoms that I bought for N1300 in October is now selling for N2400 depending on where you are buying it.
“When I opted for a cheaper one, Durex Feels, the price went up too. Before, a pack was sold at N300 but now, it is sold at N700”, says Mr Mathew Babawale, a father of four, who told our correspondent that he uses a condom during an intimate sexual relationship with his girlfriend.
The 42-year-old truck driver said, if not that they had been sensitized by some non-governmental organisations about the risk of unprotected sex, he would not have bothered about the condom price hike.
Sharing his concern with our correspondent, Babawale, said, “Due to the nature of my work, I am always on the road and many times, I travel outside Lagos to deliver goods and might be away from my family for over two weeks. I am a man, and so the urge to have sex will always be there.
“So, I always have a pack of condoms in my truck, which I use whenever I want to have sex. I usually have raw sex with my wife, and whenever we feel it’s unsafe to avoid unwanted pregnancy, we use the withdrawal method.
“But for my girlfriend and commercial sex workers, I use condoms to avoid having a second wife or contracting an infection. But if condoms become too expensive for the masses to buy, that will not stop us from having sex.
“We will ignore the risk and warning, and have it raw with our girlfriends (partners). The government should stop making things difficult for us.”
WHO on condom safety
The World Health Organisation says condoms, when used correctly and consistently, are safe and highly effective in preventing transmission of sexually transmitted infections, including HIV, and unplanned pregnancies.
The WHO said in 2020, 374 million new STIs occurred globally among adults aged 15–49 with one of the four curable STIs: syphilis, chlamydia, gonorrhoea and trichomoniasis.
According to the world global health body, the majority of these could be prevented with the correct use of condoms.
“Condoms continue to be an essential and effective tool in the prevention packages for HIV, other STIs and unplanned pregnancy. Condom use has been a significant tool to decrease transmission of HIV globally.
“98 per cent of women whose male partners use male condoms correctly in every sex act over one year will be protected from unplanned pregnancy.
“In addition, over 300 million unplanned pregnancies are estimated to be prevented each year by using contraceptives, including condoms”, the WHO said.
Sex workers lament
A female sex worker, who simply identified herself as Comfort, said she was unhappy with the spike in condom prices, lamenting that the price hike could affect her business, which is what she depends on for survival.
“Already the hardship in the country is negatively affecting our business, “she lamented, puffing on her cigarette and blowing rings of smoke into the air.
“Most customers usually do go for short-time sex (quickie) because they don’t have the money to pay full-time.
“Now that the price of condoms has gone up, we are going to increase our prices because we are the ones buying the condoms, not our clients.
“I consistently use condoms with my clients and I have told some of them to expect an increase in the prices of our services by January 2024. The increase in prices of condoms is not funny at all in this harsh economy.
“A big pack of Kiss condoms that I bought for N2,000 in October is now sold for N6,500. The N4500 difference is a lot of money and this discourages one from buying it.”
Rise in STIs and unplanned pregnancies
The price increase is a serious cause for concern, physicians and pharmacists say, adding that the situation may increase Nigeria’s already high rate of teenage pregnancies and fuel the spread of STIs, especially HIV.
A community pharmacist, Biola Paul-Ozieh, who also confirmed a rise in prices of condoms, said besides unplanned pregnancies and worsening STI spread, the development would soon lead to a scarcity of the consumable.
Paul-Ozieh who is chairman of the Healthcare Providers Association of Nigeria, Lagos State Chapter, said commercial sex workers should insist on the use of condoms with their clients irrespective of the price increase.
She said, “The price of condoms is higher than it used to be. The possibility of people discontinuing the use of condoms is there because of the price. When condom becomes too expensive people may jettison it.
“They will no longer be using it. The use of condoms is one of the behavioural changes we want to instil in people if they can’t abstain from sex or be faithful to their partners.
“We have been able to get to a level of controlling HIV infection spread in Nigeria. We need to maintain it and build on it so that people don’t relax.
“When condoms get out of the reach of the common man, it will increase unplanned pregnancies.”
Astronomical price hike
A market survey carried out by our correspondent this week showed that the prices of all brands of condoms increased sharply between September and November.
Depending on where they are bought from, a pack of Durex Pleasure Me condoms, which cost N1,400 in September, is now sold for 2500, Durex Feels which cost N300, is now sold for N700 per pack, while Durex Extra Safe, sold for N1,100, now goes for N 2,300
A Durex Performer in the period under review sold for N1500, but is now sold for N3500 a pack
The same goes for Durex Mutual Climax, which sold for N1,600 and is now up for grab for as much as N3500
Further findings revealed that smaller brands of condoms were not spared the price onslaught.
A pack of Kiss condoms, which sold for N200 in August, now sells for as much as N500, while Gold Circle condoms, which sold for between N150 and N200, is now N500
Drop in demand
Meanwhile, the spiralling effect of the price hike is hitting hard at patent medicine dealers. One of them, Mr Maxwell Ndulaka, said members of the body are worried about the astronomical increase, which he said was gradually affecting demand.
“Even if people don’t have money to buy medicine, they will have to buy condoms. Condoms sell very well.
“We normally sell condoms faster and in large quantities than any other pharmaceutical product. But now, the demand is gradually reducing because of the price hike.
“A big back of Kiss condoms that I bought for N2,000 in October, is now N6,500, while Gold Circle, which sold for N2,000 in this period is now N4,500.
“The increase is affecting our sales. Some people come to buy and if you tell them the new price, they will ask you to leave it and walk away. It is not only the prices of condoms that have gone up”, Ndulaka said looking distraught.
The patent medicine dealer, along with some of his colleagues, who spoke with our correspondent, while lamenting the condom price hike, also frowned at the spike in prices of essential drugs, noting that it was affecting their business.
Ndulaka said it was unfortunate that Nigerians prefer to buy condoms that will enable them to have safe sex than plan their lives, warning that price increases could spike infection spread among youths and commercial sex workers who are largely their customers.
Meanwhile, the pharmacists, who spoke to our correspondent earlier, stated that the increase in condom prices would soon lead to scarcity of the product just like it is being witnessed in essential drugs.”
GSK exit effect
According to experts, the increase in prices of condoms and essential drugs was caused by the depreciation of the naira and the exit of foreign pharmaceutical companies in the country.
In August, British multinational drugmaker and biotechnology company, GlaxoSmithKline, announced its exit from Nigeria.
The naira maintained a downward trend since the Central Bank of Nigeria, in June, allowed a free float of the national currency against the dollar and other global currencies.
The declining naira value led to manufacturers struggling to get raw materials, cutting production costs and jobs.
Couples opt for withdrawal method
A Lagos-based fashion designer, Mr Alice Chukwudi, told our correspondent that the issue of weight gain made her settle for condoms as a method of family planning and expressed worry that the price hike could stop her husband from buying them.
“My husband is the one that usually buys the condom and he mentioned to me last month that it is becoming too expensive. We use the Durex feels.
“If it becomes too expensive, he will not buy condoms again and will want to have unprotected sex with me or use the withdrawal method, which is risky.
“I know how long we quarrelled before he agreed to start using condoms during sex. He always insisted on having sex with me without protection because I was his wife. I have three children already and don’t want to have more”, the 34-year-old woman lamented.
Mrs Favour Ibhalu and her husband Peter, told our correspondent that a higher condom price would discourage them from using them during sex even though they have adopted it as their family planning method for over five years now.
Ibhalu said a pack of Durex Feels that he used to buy for N350 is now sold for N700.
“Even with the Gold Circle brand, the price initially increased to N200, and then suddenly, jumped to N300.
“I also use the ‘Kiss’ brand, which was N200 but is now N400. I don’t think we will be using it regularly because of the price hike. It will force us to be using the withdrawal method and see how it goes. My wife was bleeding when she used other family planning methods. That was why we settled for condoms”, he explained.
Withdrawal method unreliable – Maternal health expert
Expressing worry over the development, an Associate Professor and Consultant Obstetrician and Gynaecologist at the University of Nigeria Teaching Hospital, Ituku/Ozalla, Enugu State, Dr Uche Agu, said the use of withdrawal methods as birth control is unreliable and has a high failure rate.
He cautioned women against depending on the technique for birth control, noting that while the method works for some people, it is, however, flawed by inconsistencies and failures.
Agu stressed that a lot of men lose control at the point of orgasm and ejaculate right inside the vagina before pulling out, stressing that even those that have some level of control may have deposited some sperm cells in the initial secretions.
The gynaecologist explained, “Withdrawal method is a traditional family planning method that people use when they don’t want to adopt the standard artificial methods that include condom, injectables, intrauterine devices and implants by women.
“In the use of the withdrawal method, the man feels like he is so confident in himself that he can pull out when he wants to reach an orgasm. Well, it is not always very effective because, during the climax, the man can forget himself and ejaculate, thereby depositing the semen inside the vagina before pulling it out. That is very common.
“Even the first secretion from the urethra, which is the first slimy semen that comes out, carries sperm cells which can cause pregnancy.
“The withdrawal method is not effective. It is flawed by inconsistencies and failures. It has a high failure rate. Even though some people are very good at using it, it only works for a few .”
According to 2020 data from the WHO website, even when used perfectly every time, four per cent of people using the pull-out method will become pregnant.
Aug affirmed that the use of the withdrawal method requires discipline and caution, especially on the part of the men.
“Using withdrawal family planning method involves a lot of discipline and commitment because in some people, at that point of orgasm, they lose control and ejaculate inside the vagina. That is the truth.
“Even those that have a level of control may have emitted some sperm cells in the initial secretions before they pull out.
“So, that is why it fails. It is on the part of the man. Some of the secretions that come early before the real ejaculation contain sperm cells”, he reiterated.
A Lagos-based midwife, Ifeoma Igimi also said, “The increase in prices of condoms will lead to a rise in teenage pregnancies. It will also affect reproductive health by increasing cases of unsafe abortion.
“Women who are not using other family planning methods except condoms face a risk of having unplanned pregnancies.”
According to an article published online by Mayo Clinic – a medical centre focused on integrated health care, education, and research, the goal of the withdrawal method is to keep sperm from entering the vagina.
The publication, however, noted that one in five couples who use the withdrawal method for one year will get pregnant, adding that the withdrawal method is not as effective at preventing pregnancy as other forms of birth control.
‘Nigeria needs 1.15 billion condoms yearly’
A 2021 report on condom access and utilisation in Nigeria by the AIDS Healthcare Foundation in collaboration with the National Agency for the Control of AIDS, and the NOI Polls, revealed that Nigerians consume about 587 million condoms yearly.
It stated that Nigeria needs at least 1.15 billion condoms yearly to be able to attain 90 per cent coverage and bring down sexually transmitted diseases to a minimum.
The report indicated that Nigeria will need an extra 564 million condoms annually to achieve 90 per cent coverage across the country.
The report reads in part, “The gap between current condom use (587 million) and total need (1.15 billion) to achieve ninety per cent (90 per cent) coverage is 564 million condoms annually.”
Price hike will affect sexual, reproductive health – Experts
Medical practitioners who spoke on the development said the condom price hike will impact negatively on sexual and reproductive health.
Further speaking on the development, Biola Paul-Ozieh, a former chairman, Association of Community Pharmacists of Nigeria, Lagos State Chapter, said condom use has been promoted for decades in Nigeria and should be sustained.
She said, “People should not be discouraged from using condoms as a result of price increases. N300 is a lot of money for the average man in Nigeria if he uses three to four packs in a month. We need to address this problem. We should not give room for people to discontinue the use of condoms.
“We might get to a point where it becomes scarce and when the demand is more than the supply the price will go up. That is what we have witnessed with other drugs or consumables. Once there is scarcity, there is going to be an issue.”
The pharmacist urged stakeholders promoting sexual and reproductive health, such as the United Nations Population Fund and DKT Nigeria to continue to subsidise the consumables to make them accessible and affordable to Nigerians.
“They should ensure that condoms don’t experience heavy price increases so that the average man can afford it and continue to use it without hesitation. They should continue to bring condoms in and make them accessible.
“We appeal to them to continue to improve our reproductive health in Nigeria no matter what it takes.
“Let them continue to make condoms available to the users as and when necessary. Distribution and accessibility should be continuous. Affordability should be considered at all times”, she appealed.
Paul-Ozieh also urged the federal government to address the crisis in the pharmaceutical sector.
