HEALTH-BRAZIL: Gov’t Distributes Condoms in Schools

By Mario Osava Reprint | | Print |

Mario Osava

RIO DE JANEIRO, Aug 20 2003 (IPS) - Brazil’s ministries of health and education have begun to distribute condoms in schools as part of a stepped-up campaign to prevent unwanted pregnancies and the spread of HIV/AIDS among teenagers.

A new Health and Prevention Programme plans to hand out free condoms to some 30,000 students in five cities, including Curitiba and Sao Paulo, by year-end in the first stage of the project, which will then be gradually expanded to other parts of the country.

The novel aspect of the programme launched Tuesday in the city of Curitiba in southern Brazil is that it is being carried out by the central government, on a large-scale. Similar projects already exist at a local level.

Brazil’s public health statistics show that between 2000 and 2002, 903 new cases of HIV/AIDS were reported among teens aged 13 to 19. More than half of the cases – 58.8 percent – involved adolescent girls.

Unwanted pregnancies are another problem targeted by the programme. Between early 1999 and April 2003, 210,946 girls between the ages of 10 and 19 gave birth in public hospitals, while 219,834 10 to 19-year-olds were treated in public hospitals for medical complications arising from illegal abortions.

Those figures reflect the increasingly early age at which adolescents are becoming sexually active, often without taking precautions to prevent pregnancies and sexually transmitted diseases (STDs) like AIDS.

Although abortion is still illegal in Brazil except in cases where the mother’s life is at risk, many are practiced in a clandestine manner in private clinics, often causing medical problems for which the women turn to public hospitals for help.

It would have been even better to begin distributing free condoms in schools much earlier, in the 1980s, when HIV, the AIDS virus, first appeared in Brazil, said the head of the Health Ministry’s office on STDs/AIDS, Alexandre Granjeiro.

But ”it is only now that we have the political and institutional conditions” that have made it possible for us to launch the programme, he explained to IPS.

He added that the Education Ministry has dared to directly take part in such a controversial project for the first time due to the fact that Brazil now has a government that is ”bold” enough to undertake such an initiative, which combines the efforts of two ministries.

He was referring to the administration of President Luiz Inacio Lula da Silva, a former trade unionist and the head of the leftist Workers’ Party, who took office in January.

The project is also innovative, Granjeiro added, in that it combines the distribution of condoms in public schools with education on STDs and drug use.

He noted that in surveys carried out before the project began to be implemented, 84 percent of the parents interviewed were in favour of sex education and the distribution of condoms in schools. A similar proportion of the teachers surveyed were also in favour of the measures.

The programme launched Tuesday by Health Minister Humberto Costa and Secretary of Middle and Technical Schools Antonio Ibañez will be gradually expanded next year, with the ultimate goal of handing out condoms to 2.5 million 13 to 19-year-olds by 2006.

Meeting that target would involve the distribution of 235 million condoms a year.

Around 14 million of the 17 million 13 to 19-year-olds in Brazil, a country of 171 million, attend school.

To extend the prevention efforts to students and non-students not covered by the programme, the Health Ministry’s STDs/AIDS office is preparing similar projects that will target two high- risk populations, said Granjeiro.

The first will focus on the violence-ridden shantytowns that ring Brazil’s large cities, with the aim of prompting grassroots community action, while the second will focus on juvenile delinquents held in reform schools.

The Health Ministry is alarmed by the fact that HIV/AIDS has been spreading faster among teenage girls than boys since 1999, with nearly two HIV-positive teenage girls today for every HIV- positive teenage boy.

Granjeiro said more women are being infected with HIV/AIDS today for several reasons. First of all, girls are becoming sexually active at earlier ages, often with older men. Secondly, many do not use condoms when they are in a stable relationship, despite the fact that their partners may not be faithful, or use birth control methods that do not prevent AIDS.

Brazil has successfully curbed the spread of AIDS by means of a programme through which antiretroviral drugs are made available to all AIDS patients free of charge. Around 125,000 AIDS patients currently receive the anti-HIV drug regimen through the public health programme, which has been held up by the World Health Organisation as an exemplary initiative.

There are an estimated 600,000 Brazilians living with HIV, only half of the total projected by international institutions.

The mobilisation and participation of patients and non- governmental organisations (NGOs) has been a key factor in Brazil’s success in combating the epidemic.

The Brazilian Interdisciplinary AIDS Association (ABIA) is pleased with the health and education ministries’ joint initiative, although a spokesman for the NGO told IPS that ”large- scale random distribution of condoms alone is insufficient.”

To make prevention efforts effective, the distribution of condoms must be accompanied by sex education and training of teachers, said the activist.

Teachers do receive some training on the question, mainly through televised courses, but ”their school administrations do not always allow them autonomy or the conditions” necessary for providing effective sex education, he added.

The ABIA spokesman also said it was a positive thing that Brazil can take advantage of the experience of condom distribution programmes in the United States and Europe.

Similar projects already exist at a local level. For example, the Adolescent Health Research Group at the Rio de Janeiro State University has been involved in the prevention of STDs and HIV/AIDS since 1994, focusing on reproductive health and the distribution of condoms in schools and poor neighbourhoods.

Prevention efforts involving sex education and the use of condoms ”must begin at an early age, which is why the government’s approach is appropriate,” Evelyn Eisenstein, one of the doctors in the Research Group, remarked to IPS.

The Research Group, based in the Rio de Janeiro State University teaching hospital, draws many young people seeking information and medical consultations on sex and STDs. The ”typical adolescent looking for assistance is already sexually active, but has doubts and fears,” said Eisenstein.

The teenagers generally have some level of awareness about AIDS, but ”little comprehension of the risks” they themselves face.

”They think ‘that won’t happen to me’,” said the doctor. Some of the youngsters who visit the Research Group already test positive for HIV, and are provided with medical assistance and antiretroviral drugs.