ANTANANARIVO, Oct 1 (AFP) - Efforts to increase the use of condoms in Madagascar to prevent the spread of HIV and AIDS have failed dramatically, largely because of the opposition of church leaders.
Just two percent of women and four percent of men questioned by the Indian Ocean island's National Institute of Statistics said they had used a condom during their most recent sexual activity.
The survey was carried out between last November and March and involved 7,000 sexually active respondents who knew about the existence of HIV and AIDS.
"I am firmly opposed to the use of the condom as a means of fighting AIDS, because it promotes promiscuity," Armand Razafimahefa, until August the head of the country's protestant church, told AFP.
"Why not spend this money to find a vaccine for AIDS, instead of promoting condoms? There's lots of money involved," he said.
"I agree with the cardinal on this," he added. Cardinal Gaetan Armand Razafindratandra, the bishop of Madagascar, has on several occasions spoken out against the use of condoms.
Madagascar's churches -- Roman Catholics, Protestants, Lutherians and Anglicans -- boast between eight to 10 million followers out of a total population of 17 million.
At the forefront of condom promotion is a US non-governmental organisation, Population Services International (PSI), which is funded by the US government.
PSI has distributed condoms across the island at the subsidised price of 500 francs (four euro cents) a piece.
"We sold 11 million in 2003 and believe we have 80 percent of the country covered," PSI Director of Operations in Madagascar Lalah Rambeloson told AFP.
"But some outlets refuse (to accept the condoms) or throw them away because of religion," he added.
This week, the National Committee for the Fight Against Aids, christened the condom "Fimailo," a word in the Madagascan language meaning "it's good but be careful."
"We want to counter the demonisation attempts and make it something people use a lot," explained the committee's executive secretary, Fenosoa Ratsimanetrimanana.
The campaign has brought in best-selling pop musicians to spread the word on specially recorded cassettes.
Last December, President Marc Ravalomanana declared the fight against AIDS a "national cause." Last year, the government spent 300 million dollars in the campaign against the disease.
According to a neonatal survey released in July 2003, the HIV prevalance rate in Madagascar is 1.1 percent.
The study, which looked at relatively young pregnant women living in rural areas in Madagascar, found that the rate of HIV-infection among married women -- just over 1.2 percent -- was higher than among their single counterparts.
"If married women have AIDS, their husbands do too. And the husband often 'brought it home' after seeing other women who are infected, and so on and so forth," Andre Ndikuyeze, the representative of the UN World Health Organisation (WHO) in Madagascar, said at the time.
"Madagascar has entered a phase where AIDS will become generalised," he warned.
"Madagascar is not a special case, just a time bomb," Peter Piot, the head of the UN umbrella body dedicated to fighting the spread of HIV and AIDS, said in March during a visit to the island.
Piot has strongly criticised the Cardinal's declarations.
"Science is not the province of the church or cardinal's, just as theology is not my province," he said.
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