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Terms of Reference: Condom demonstration clip & dissemination of condom plan to 3 provinces through workshops

South Africa is home to the largest number of people living with HIV in the world. The
most recent mathematical model of the HIV epidemic in South Africa, Thembisa 4.3
estimates that the total number of people living with HIV in 2019 was 7.8 million, 7.3
million of them are adults 15 years and older. In 2019 total (all ages and sexes) HIV
prevalence was estimated at 12.9% with adult women disproportionately affected at 21.3%
and adult men at 13.4 %. Since 2010, the gaps across the HIV testing, treatment and viral
suppression cascade have steadily been closing. South African men, including boys and
adolescents experience particularly poor health outcomes across a variety of measures.
Evidence suggest that this is attributed to men’s poor health-seeking behaviour, which
results in them presenting late with advanced stages of illness. Men account for 56.6% of
all TB-deaths recorded in the country while non-communicable diseases are the leading
cause of death among men older than 45 years. Evidence highlights the seriousness of STIs
as a public health problem and as a risk factor for both HIV infection (Kularatne et al.,
2018; SANAC, 2017) and poor reproductive health outcomes (SANAC, 2017) More than
1.4 million STIs were treated in South Africa in 2017 (Department of Health, 2018)
Furthermore in 2017, children born to mothers in age groups 20 to 34 made up 73% of all
births and adolescent births of mothers aged 10 to 19 contributed 11%. The proportion of
women aged 15–19 who have begun childbearing rises rapidly with age, from 4% among
women at age 15 to 28% among women at age 19. Recent studies indicate high HIV
prevalence among men who have sex with men (MSM) estimated at 25.7%, with much
higher prevalence in major cities such as Johannesburg (43%), eThekwini (30%) and Cape
Town (27%).

Communication is essential to negotiating safer sex and promoting correct and consistent
use of the condoms. Historically, condoms have been at the centre of the response to HIV
and have had a transformative impact on the trajectory of HIV epidemics worldwide, and
today they are a well-known and widely used method to prevent HIV transmission, STIs
and unplanned pregnancies. John Stover Futures- group Institute presented a modelling
analysis that assessed the role of condom use and how the condom can play a role in the
HIV epidemic. Based on the model, an estimated 50 million HIV infections have been
averted by condom use since the onset of the epidemic. Furthermore, evidence show that
scale-up of condom promotion and distribution is important in achieving global goals, and
that condoms are cost-effective in most settings and comparably much cheaper than other
programmes regarding cost per infection averted. Stover underlined the importance of
smart targeting and accessibility of condom for all vulnerable groups.

The Department of Health has finalized the National Condom Communication Plan and the
overall goal of this plan is to increase consistent condom use and the adoption of safer
sexual behaviours, especially among people 15–24 years old and key populations. The
Department has requested UNFPA to provide technical and financial support to support of
the roll out of the plan.

The Consultant will undertake the following activities:

1. Development of a condom demonstration clip
2. Support dissemination of condom plan to 3 provinces through workshops