Dear Editor,

In a recent editorial you wrote, with the intention of educating Ms Desiree Edghill, the HIV-AIDS prevention activist, "The debate about the safety of condoms has been over for months now. The truth is that condoms, used 'consistently and correctly' are 100 per cent safe." (SN December 15, 2001) Persons who are informed in this area no longer believe that, although it may be a comforting thought.Your editorial cites sources of the highest prestige, but not of the highest degree of freedom. You cite the WHO and the CDC as well as the NIH. These organisations have been silent on many important health issues because they act in an interest-ridden climate.

First, it is not true that "a condom is a condom". It was thought not long before the publication cited in your editorial that condoms treated with Nonoxyl 9 improved protection against HIV infection. It was later found after tests that the N9 spermicide was effective in the lab, but not half as effective when used by sex partners. One of us is aware that some condoms on sale here carry a statement that they are N9 treated.Some who advocate condoms for risk reduction warn that the condoms should read "for disease protection".

Surely those who are compulsive engagers in sex should protect themselves as much as possible, but they should not think that a condom is a guarantee against infection. A British medical journal has reported a fall in the reliability rating of condoms from 97 per cent to 69 per cent.

Those of us who are active on this front agree that we should do or say nothing to lead young people to reckless behaviour. We must also not underestimate their ability to understand that condoms have limitation and are not anywhere 100 per cent guaranteed, and no reputable health agency has ever said they were. We must present young people, in fairness to them and their lively intelligence, with the levels of safety open to them. One way to put it is, "Sex with a condom is not safe sex. It is safer than without a condom, but not safe."Should an activist prefer to be responsible for telling young people that condoms are 100 per safe and then be confronted with a case in which this turns out not to be so? We can only tell them at that stage, "you did not use it 'consistently or correctly."

It will be a sad day when the debate about the safety of condoms, or about anything regarding health, is over. These are days of thousands of centres of independent research, without the baggage of the WHO and others.

One example should help. We hear a lot about vaccines and their undoubted effectiveness. Whoever told us, in our countries, that there is a Helsinki protocol about the application of vaccines? Yet they are launched on whole populations without the safeguards, which are built in their standard application.Everyone is silent just because vaccines are mainly beneficial in the present state of our wrecked immune systems. Beggars must not choose standards.

The whole treatment of health information needs a serious revision. Recognition of the valuable work of high-profile organisations should not blind us to the fact that they are working to a script. They admit much only after the light breaks around them.

The tests to which you refer as leading to the very guarded opinion given out by any person who had an SI had to be treated for that condition before taking part in the test. Condom users who are not in that controlled situation may be disappointed with the outcome.

Even the phrase "being faithful to one partner" is insufficient. A & B must both be uninfected at the start of the partnership. Another condition is that from B's point of view, not she alone must be faithful to one partner, and from A's point of view, not he alone must be faithful to one partner.

Ms Edghill is right, in our opinion. There is no "big change" in attitudes. The major events, the walks and the drama, prepare the atmosphere for getting at the conscience, direct education. It is hard to get the atmosphere without these events.

Conscience work takes place best in much smaller groups. Our experience is that when young people come together, on an open invitation, in a session, there is free, frank discussion, questioning and above all argument. There must be trained persons there, as well as those with only a moral position, to answer and engage, and also to admit ignorance. In such sessions information can be shared, questioned, understood and weighed. Eventually a person's defences are stronger the more the person knows. Conviction is what matters. All of the five sessions held so far seem to have gone well.

What we need, if we are to help achieve that "big change" (if we are to help effectively in changing the order) is thoroughgoing reproductive health education. Much of the opposite may be present in the social environment. We may as well face the facts.

Yours faithfully,

Avette Richards

Eusi Kwayana