CONTENTS

         Chapters
  1. The Toll of STDs
  2. Reducing the Toll of STDs
  3. Managing STDs
  4. Diagnostic and Treatment Tips
  5. Getting Services to the People
  6. Getting People to Services
  7. Promoting Prevention—Condoms and Monogamy

HIGHLIGHTS

Population Reports is published by the Population Information Program, Center for Communication Programs, The Johns Hopkins School of Public Health, 111 Market Place, Suite 310, Baltimore, Maryland 21202-4012, USA


Volume XXI, Number 1
June, 1993

Promoting Monogamy

Efforts to promote monogamy have encouraged men to stop having sex with prostitutes and urged couples to be faithful. Also, programs have encouraged youth to delay sexual intercourse or abstain until they get married. Most such efforts have been a part of AIDS prevention programs. For example:

  • In the Philippines a television commercial broadcast in 1992, part of an AIDS prevention campaign, portrayed young men in a locker room discussing their visit to prostitutes the night before. One man warns them, however, that having sex with prostitutes is dangerous and reminds them about a friend who is sick (289).
  • In Uganda monogamy is promoted with the phrases "Zero grazing" ("zero grazing" means staying with one partner), "Love carefully," and, for men in polygamous marriages, "Stay within your own paddock" (130, 214).
  • The Zaire AIDS prevention program combined promotion of monogamy and condoms in the slogan "Love faithfully, or at least with prudence" (134).
  • The Swiss AIDS education program uses the slogan "Stay faithful to one partner" in advertising directed at married couples (179).
To gauge their impact, these programs have measured intent, knowledge, or reported behavior. For example:

  • Pre-tests and post-tests of the promotion in the Philippines found significant increases in the percentages of men who agreed with the statements, "If I am going to have sex, I will stick to one partner" and "I will not sleep with prostitutes" (289).
  • In Uganda surveys of adults in rural and urban areas in 1988 found that almost 90% were aware that mutual monogamy prevented the transmission of HIV (86).
  • In Switzerland surveys have found that the median number of reported lifetime sexual partners among people ages 17 to 30 declined from 3 to 2 between 1987 and 1991. The change was not statistically significant but may suggest a trend (74). During the same period condom use in this group increased from 8% to 52% (75).
Isolating the effect of programs is difficult, of course. In Switzerland, for example, sex education in the schools may also be influencing behavior. More research is needed on the impact of programs that promote monogamy as well as on ways to measure behavior change.

Sexually transmitted diseases are both a medical and a social problem. The means to cure many STDs and to prevent all of them have long existed. But health care providers are still struggling to make STD diagnosis and treatment widely available throughout the world. Also, they are just learning how to persuade people to seek effective treatment, to use condoms, and to have fewer sexual partners. And they are just beginning to involve providers of primary health care, including antenatal care and family planning, who may be able to play a larger role in STD management and prevention. Such efforts can prevent infertility, avoid congenital infections, and slow the spread of AIDS.


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