Case 4 5 AIDS Condoms and Carnival
Case 4 5 AIDS Condoms and Carnival
Case 4 5 AIDS Condoms and Carnival
BRAZIL
Half a million Brazilians are infected with the virus that causes
acquired immunodeficiency syndrome (AIDS), and millions more
are at high risk of contracting the incurable ailment, a federal study
reported. The Health Ministry study is Brazils first official attempt
to seek an estimate of the number of residents infected with human
immunodeficiency virus (HIV). Many had doubted the governments prior number of 94,997. The report by the National Program for Transmissible Diseases/AIDS said 27 million Brazilians
are at high risk to contract AIDS, and another 36 million are considered to be at a medium risk. It said Brazil could have 7.5 million
AIDS victims in the next decade.
If we are going to combat this epidemic, we have to do it now,
said Pedro Chequer, a Health Ministry official. Chequer said the
Health Ministry would spend $300 million next year, distributing
medicine and 250 million condoms and bringing AIDS awareness
campaigns to the urban slums, where the disease is most rampant.
Last month, Brazil became one of the few countries to offer a
promising AIDS drug free to those who need it. The drug can cost
as much as $12,000 a year per patient.
AIDS cases in Brazil have risen so dramatically for married
women that the state of So Paulo decided that it must attack a
basic cultural practice in Latin America: Their husbands dont
practice safe sex. Last month, the government of Brazils megalopolis started promoting the newly released female condom.
Many of the new AIDS cases in Brazil are married women who
have children, according to a report released last month at the PanAmerican Conference on AIDS in Lima, Peru. Worldwide, women
constitute the fastest-growing group of those diagnosed with HIV.
And of the 30.6 million people who are diagnosed with HIV, 90
percent live in poor countries.
One Brazilian mother, Rosana Dolores, knows well why
women cannot count on male partners to use condoms. She and
her late husband never thought of protecting their future children
against AIDS. We were married. We wanted to have kids, says
Dolores, both of whose children were born HIV positive. These
days, I would advise young people to always use condoms. But
married couples . . . who is going to?
Brazil, with its 187 million people and the largest population
in South America, has the second-highest number of reported HIV
infections in the Americas, after the United States, according to a
report released by the United Nations agency UNAIDS.
Public health officials say one reason why AIDS prevention efforts have failed is that many Brazilians just dont like
condoms. Although use in Brazil has quadrupled in the past
six years, it is still the least popular method of birth control
a touchy issue in the predominantly Roman Catholic country.
Another reason is that condoms cost about 75 cents each, making them more expensive here than anywhere else in the world,
health officials say.
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Plus, Latin-style machismo leaves women with little bargaining power. Only 14 percent of Brazilian heterosexual men used
condoms last year, according to AIDSCAP, an AIDS prevention
program funded by the U.S. Agency for International Development. In other studies, many women said they would not ask their
partner to use a condom, even if they knew he was sleeping with
others.
Women are afraid of asking their men to have safe sex, afraid
of getting beaten, afraid of losing their economic support, says
Guido Carlos Levi, a director at the health department at Emilio
Ribas Hospital. This is not Mexico, but were quite a machoistic
society here.
The frequency with which Latin men stray from monogamous
relationships has compounded the problem. In studies conducted
in Cuba by the Pan American Health Organization, 49 percent of
men and 14 percent of women in stable relationships admitted they
had had an affair in the past year.
In light of statistics showing AIDS as the number one killer
of women of childbearing age in So Paulo state, public health
officials launched a campaign promoting the female condom. The
hope is that it will help womenespecially poor womenprotect
themselves and their children. But the female condom seemed unlikely to spark a latex revolution when it hit city stores. The price
is $2.50 apiecemore than three times the price of most male
condoms.
The Family Health Association is asking the government to
help subsidize the product and to cut the taxes on condoms that
make them out of reach for many poor Brazilians. Were looking for a pragmatic solution to prevent the transmission of HIVAIDS, group President Maria Eugenia Lemos Fernandes said.
Studies show there is a high acceptance of this method because
its a product under the control of women.
While 75 percent of the women and 63 percent of the men in a
pilot study on the female condom said they approved of the device,
many women with AIDS say they would have been no more likely
to have used a female condom than a conventional one.
Part of the problem is perception: 80 percent of women and
85 percent of men in Brazil believe they are not at risk of contracting HIV, according to a study conducted by the Civil Society for
the Well-Being of the Brazilian Family.
Also at risk are married women, 40 percent of whom undergo
sterilization as an affordable way of getting around the Catholic
churchs condemnation of birth control, health officials noted.
Its mostly married women who are the victims. You just
never think it could be you, says a former hospital administrator
who was diagnosed with the virus after her husband had several
extramarital affairs. He died two years ago. I knew everything
there was to know about AIDSI worked in a hospitalbut I
never suspected he was going out like that. He always denied it,
she says.
While HIV is making inroads in rural areas and among teenagers in Brazil, Fernandes says it doesnt have to reach epidemic
proportions as in Uganda or Tanzania. There is a very big window
of opportunity here.
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INDIA
S. Manis small barbershop in a southern Indian city looks like any
other the world over. Its equipped with all the tools of the trade:
scissors, combs, razorsand condoms, too.
A blue box full of free prophylactics stands in plain view of his
customers as Mani trims hair and dispenses advice on safe sex,
a new dimension to his 20-year career. I start by talking about
the family and children, Mani explains, snipping a clients moustache. Slowly, I get to women, AIDS, and condoms.
Many Indian men are too embarrassed to buy condoms at a
drugstore or to talk freely about sex with health counselors and
family members. Theres one place where they let down their hair:
the barbershop. So, the state of Tamil Nadu is training barbers to
be frontline soldiers in the fight against AIDS.
Programs like the barber scheme are what make Tamil Nadu, a
relatively poor Indian state thats home to 60 million people, a possible model for innovative and cost-effective methods to contain
AIDS in the developing world.
Six years after it was first detected in India, the AIDS virus is
quickly spreading in the worlds second most populous nation. Already, up to 2.4 million of Indias 1 billion people are infected with
HIVmore than in any other country, according to UNAIDS, the
United Nations AIDS agency.
But faced with more immediate and widespread health woes,
such as tuberculosis and malaria, officials in many Indian states
are reluctant to make AIDS prevention a priority. And in some
states, the acquired immunodeficiency syndrome is regarded as a
Western disease of decadence; officials deny that prostitution and
drug use even exist in their midst. Some Indian states are still
in total denial or ignorance about the AIDS problem, says Salim
Habayeb, a World Bank physician who oversees an $84 million
loan to India for AIDS prevention activities.
Tamil Nadu, the state with the third-highest incidence of
HIV infection, has been open about its problem. Before turning
to barbers for help, Tamil Nadu was the first state to introduce
AIDS education in high school and the first to set up a statewide
information hotline. Its comprehensive AIDS education program targets the overall population, rather than only high-risk
groups.
In the past two years, awareness of AIDS in Tamil Nadu has
jumped to 95 percent of those polled, from 64 percent, according
to Operations Research Group, an independent survey group. Just
two years ago, it was very difficult to talk about AIDS and the
condom, says P. R. Bindhu Madhavan, director of the Tamil Nadu
State AIDS Control Society, the autonomous state agency managing the prevention effort.
The AIDS fighters take maximum advantage of the local culture to get the message across. Tamils are among the most ardent
moviegoers in this film-crazed country. In the city of Madras,
people line up for morning screenings even during weekdays. Half
of the states 630 theaters are paid to screen an AIDS-awareness
short before the main feature. The spots are usually melodramatic
musicals laced with warnings.
In the countryside, where cinemas are scarce, a movie mobile
does the job. The concept mimics that used by multinationals, such
as Colgate-Palmolive, for rural advertising. Bright red-and-blue
trucks ply the back roads, blaring music from well-known movie
soundtracks whose lyrics have been rewritten to address AIDS issues. In villages, hundreds gather for the show, on a screen that
pops out of the rear of the truck.
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Part 6
Supplementary Material
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JAPAN
London Okamoto Corporation, the joint venture company between
London International Group and Okamoto Industries, announced
the Japanese launch of Durex Avanti, the worlds first polyurethane
male condom.
This is the first time an international condom brand will be
available in Japan, the worlds most valuable condom market,
which is estimated to be worth 260 million ($433 million). Durex
Avanti has already been successfully launched in the United States
and Great Britain and will be launched in Italy and other selected
European countries within a year.
Durex Avanti condoms are made from Duron, a unique polyurethane material twice as strong as latex, which enables them to be
made much thinner than regular latex condoms, thereby increasing
sensitivity without compromising safety. In addition, Durex Avanti
condoms are able to conduct body heat, creating a more natural
feeling, and are the first condoms to be totally odorless, colorless,
and suitable for use with oil-based lubricants.
Commenting on the launch, Nick Hodges, chief executive of
LIG, said; Japan is a very important condom market; with oral
contraceptives still not publicly available, per capita usage rates
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for condoms are among the highest in the world. Our joint venture
with Okamoto, Japans leading condom manufacturer, gives us instant access to this strategically important market.
The joint venture with Okamoto, which is the market leader in
Japan with a 53 percent share, was established with the specific
purpose of marketing Durex Avanti. Added Takehiko Okamoto,
president of Okamoto, We are confident that such an innovative
and technically advanced product as Durex Avanti, coupled with
our strong market franchise, will find significant consumer appeal
in Japans sophisticated condom market.
Durex Avanti, which is manufactured at LIGs research and development center in Cambridge, England, has taken over ten years
to develop and represents an investment by LIG of approximately
15 million.
QUESTIONS
1. Comment on the Brazilian and Indian governments strategies
for the prevention of AIDS via the marketing of condoms.
2. How is the AIDS problem different in the United States
compared with Brazil and India?
3. Would the approaches described in Brazil and India work in
the United States? Why or why not?
4. Suggest additional ways that London International Group
could promote the prevention of AIDS through the use of
condoms worldwide.
5. Do you think it would be a good idea for Coke and Pepsi to
participate in a condom distribution program in India, Brazil,
and the United States?
Sources: Half a Million Brazilians Are Infected with the AIDS Virus, Associated
Press, December 21, 1996; Andrea McDaniels, Brazil Turns to Women to Stop
Dramatic Rise in AIDS Cases. So Paulo Pushes Female Condom to Protect Married
Women from Husbands, but Costs of Devices Are High, Christian Science Monitor,
January 9, 1998, p. 7; Brazil to Hand out 10 Million Condoms during Carnival,
Chicago Tribune, January 19, 1998, p. 2; Miriam Jordan, India Enlists Barbers in the
War on AIDS, The Wall Street Journal, September 24, 1996, p. A18; Caro Ezzzell,
Care for a Dying Continent, Scientific American, May 2000, pp. 96105; Ginger
Thompson, In Grip of AIDS, South Africa Cries for Equity, The New York Times,
p. 4; Roll Out, Roll OutAIDS in Brazil, The Economist, July 30, 2005, p. 376;
AIDS Campaign May Soon Piggyback on Pepsi, Coke, http://www.HindustanTimes.com, August 30, 2005; A Portrait in RedAIDS in Brazil, The Economist,
March 15, 2008, p. 38. Also see the Web sites http://www.lig.com and http://www
.durex.com.
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