last 4 july In Cuba published on the lack of condoms in the province of Santi Spiritus. According to the central media, since March last year, MINSAP has not been supplying the city with condoms. At that time, from a plan of more than 2.8 million units, only 54,000 units arrived in the province.
According to the publication, condoms are guaranteed only to so-called “key populations”, which include transgender or transgender people, men who have sex with other men (MSM), people who have sex for money or other forms of compensation, as well as their partners and people living with HIV. These people “are given a minimum annual package of 21 condoms and 10 lubricants, which does not cover their needs.” Given the lack of condoms, the residents of Sancti Spiritus and the rest of the island’s population have no choice but to buy them for between 50 and 100 pesos on the unofficial market.
Stock shortages: a recurring problem
The lack of condoms on the island is a chronic or at least intermittent problem. In the March 30, 2013, acknowledgment of receipt section, the then National Director of Epidemiology of MINSAP responded to two users, explaining that the lack of condoms in Holguín and Villa Clara was not due to a “continued shortage” but to a “specific lack” that was caused by increased demand and a change in the expiration date of those they had in stock.
One year later In Cuba published on the lack of condoms in various provinces of the country. The labeling problems already mentioned, referred to by the representative of the Ministry of SAPO, continued. At that time, it was the lack of staff to change labels with expiration dates that slowed down the flow of in-demand goods to pharmacies.
In January 2020, the crisis of two brands sold on the island again emerged: Vigor and Momentos. Then another report from rebellious youth described condoms as “a scarce product” or “difficult to obtain” due to their “low market availability”. As an alternative, he even mentioned the female condom, which was not available on the island either.
From goat bladder to latex
Few people know that the condom has an international day. Every February 13, a tribute is paid to this tool of sexual and reproductive health, which has a history of thousands of years. In fact, the first mention of a condom dates back to 3000 BC. C. According to legend, Minos, king of Crete, used a goat’s bladder to protect his sexual partners from his semen, which contained “serpents and scorpions.” Others say that his wife, Pasiphae, inserted the animal’s bladder into her vagina to avoid being infected by the supposed animals Minos carried in his semen. Both are equivalent to the male and female condoms of antiquity.
Far more complex, and with DNA samples from the pharaoh, was the sample found by archaeologist Howard Carter and his team in Tutankhamun’s tomb. It was made of “fine linen soaked in olive oil” and was tied to a rope that the researchers said hung from the pharaoh’s waist. Apparently, the Egyptian embalmers were concerned about their king’s sexual health even in the afterlife.
The history of condoms owes much to STIs (sexually transmitted infections). In ancient Rome, the condom became popular to avoid contracting syphilis. Apparently the knowledge of linen condoms was lost, and the idea of using animal parts such as the intestines and bladder to protect was revived.
More than 1700 years later, mutton gut pods were again used at the court of King Charles II of England. It is believed that the method was rediscovered by a doctor named Condom, to whom we owe the name of the condom.
A more modern version is by Charles Goodyear, who pioneered the use of rubber in both condoms and tires. However, in the 1920s, this material was replaced by latex.
very serious problem
In a 2018 survey in Cuba that covered almost 50% of people living with HIV/AIDS (PLHIV) in the country, 79.9% of men and 72.3% of women indicated that not using a condom caused them to contract the virus. In general, this is about 78.4% of cases.
For the researchers responsible for the study, while 81.4% of men and 78.2% of women said they always used condoms in their sexual relationships was positive, it was very worrying that one in five PLHIV were at risk of reinfecting or infecting others without systematically protecting themselves. Over the course of six years, researchers have found a decline in the number of people who always protect themselves. For their part, they have noticed an increase in the number of those who say they “eventually” use condoms. This slows down the ability to achieve impact on prevention and morbidity and mortality from STIs.
On the other hand, as part of the social dynamics that our country is experiencing, it was also found that among PLHIV there was an increase in the number of people who had paid sex for both sexes, which was much higher than in the 2012 study. In addition, the use of condoms was absent in more than 27% of cases when paid sex took place. Finally, 8.9% of PLHIV contracted some form of sexually transmitted infection in the past year. Will all this be due to the repeated lack of condoms?
Incidence of some venereal diseases in Cuba
Analyzing the behavior of the most prominent sexually transmitted infections (gonorrhea, syphilis and HIV/AIDS) from 2000 to 2020 in Cuba, we see uneven behavior. At the beginning of the century, the incidence of gonorrhea was extremely high, about 20,000 cases per year; in 2020, this figure has steadily fallen to 2,770 new cases.
On the other hand, syphilis is also on a downward trend, from 9,199 in 2000 to 4,520 two decades later. However, this disease had a minimal incidence in 2010 – 1445 cases. For HIV, the century started with 258 new cases, then rose to an alarming number of 764 in 2010. The past decade has seen a downward trend, with 243 new cases reported in 2020.1.
In this sense, we cannot argue that the inconsistent presence of condoms on the market was a determining factor in the incidence of these diseases. However, in a certain number of cases, they could be a contributing factor, and, without any doubt, their lack does not contribute to the sexual health of the population.
On the other hand, we must not forget that, as we saw in the article on this topic, HIV/AIDS is the 22nd cause of death in our country. Between 2020 and 2021, 767 people with the virus died on the island. So it’s not a minor health issue.
More than three diseases
It is not only gonorrhea, syphilis, and HIV/AIDS, diseases that trouble and preoccupy the public health authorities. Hepatitis B and C are also sexually transmitted and are associated with liver cancer. While the human papillomavirus (HPV) is the cause of 85% of cases of cervical cancer, which affects 21 out of every 100,000 women in our country. This virus is also the first cause of throat cancer. There is a vaccine for hepatitis in the national health system, but not for HPV.
Human papillomavirus vaccine is the duty of Cuban public health
In addition, sexually transmitted diseases not only affect people’s lives by causing death or cancer. These infections play a known role in both male and female infertility.
Thus, the chronic shortage of condoms in the Cuban pharmacy network over the past ten years has had a negative impact on the health of the population. After huge efforts in public benefit campaigns and sexuality education, shortages and high prices undermine the efforts of health authorities. They also contribute to the growth of sexually transmitted infections and other associated diseases such as cancer of the liver, cervix and throat.
In addition, they negatively affect the reproductive health of Cuban men and women.
1 Sources: Statistical Yearbook of Health 2017 and 2021.
Chlamydia trachomatis, unknown enemy
Chlamydia trachomatis infection is the most common bacterial sexually transmitted disease (STD) worldwide. WHO estimates that in 2012 there were 131 million new cases of chlamydial infection (or chlamydia) worldwide, out of approximately 128 million existing cases. 10-40% of people with gonorrhea also have a chlamydial infection.
You can get chlamydia through unprotected vaginal, anal, or oral sex with an infected person. It can also be passed from mother to child during childbirth. Skin-to-skin contact with the genitals is a well-established mechanism for the spread of chlamydia, as is eye contact with infected vaginal fluid or semen. Therefore, the correct and consistent use of condoms greatly reduces the risk of infection.
Approximately 70% of women and 50% of men show no symptoms. When symptoms of a chlamydial infection appear, they can take many forms. Women may experience irregular vaginal discharge, pain or burning when urinating, and bleeding after intercourse and between periods. In men, there may be discharge from the penis, pain or burning when urinating, and sometimes pain in the testicles.
An untreated chlamydial infection can cause serious complications. Young women often have inflammation of the fallopian tubes. This can cause pelvic inflammatory disease (PID). It can also lead to ectopic pregnancy and the inability to have children.
Men have fewer health problems. The most common is inflammation of the tube that stores and transports sperm (epididymitis). In rare cases, this can lead to infertility. The risk of secondary complications may increase with repeated infections.
A chlamydial infection can almost always be completely cured with antibiotics. Azithromycin, doxycycline, or some fluoroquinolones such as ciprofloxacin or levofloxacin are used.