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Research early on in the epidemic showed that 40 to 70% of men who claimed they use condoms 100% of the time in fact did not use them for every act of intercourse.

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Therefore questions of condom efficacy have to be addressed and misapprehensions corrected.

In these circumstances, it is easy to see why condoms sometimes fail, even in consistent users.

In addition, however, people are not consistent in their use of condoms, and may not even be consistent when they claim to be, or think they are.

One widely quoted remark of this nature came from Ugandan President Yoweri Museveni who, at the Fifteenth International AIDS Conference in Bangkok in 2004, advocated for HIV prevention based on “optimal relationships based on love and trust instead of institutionalised mistrust, which is what the condom is all about…I think of condoms as an improvisation, not a solution”.

(See the text of Museveni’s speech.) Museveni later complained of being misunderstood and signed an article in The Lancet saying that condoms formed a valuable part of HIV prevention.

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