Listen to Africa Live

Every day, 14,000 people are infected with HIV in sub-Saharan Africa, and the pandemic is devastating countries like Botswana, Mozambique and Zambia.

But despite continued campaigning, expert advice about condom use is being ignored. According to the United Nations, only 3% of Africa's sexually active population use condoms.

"People consider that their relationship is more important for them than the risk that they are facing," Ethiopian doctor Lewel Ayelal told the Africa Live phone-in programme broadcast on the BBC World Service.

He said one barrier to condom use is a lack of access to condoms across the continent, but the other main barrier is cultural.

'Against tradition'

The paradox is that in that in many people's minds, the relationship between condoms and Aids is firmly established.

Aids is not killing intimacy, lack of education about eroticizing safer sex is Joan R. Ferguson, US Is Aids killing intimacy?

Many believe, therefore, that wearing one implies a lack of trust in their partner and harms intimacy.

"We say, 'use condoms because you don't know if someone's safe, you don't know if you can trust them'," said Leah Hossam, an Africa Live contributor in the USA.

"So there's a connection between the use of condoms and showing that you're either not trusting your partner, or that you are not trustworthy yourself.

"This connection makes it difficult to introduce [condoms] into relationships because people will choose their relationships over their own safety."

Others were simply resistant to condoms because they felt they prevented intimacy.

"I have unprotected sex because there is no sweetness when you are doing true love with a condom," said Bwana X, a farmer from a rural region in Zambia.

"The way I grew up, it is taboo to use a condom. We believe in ritual cleansing, where if my brother dies, I will have to sleep with the woman of my brother and make her clean.

"So I sleep with that wife without a condom."

However Bwana X's comments were dismissed by Dr Vincent Bagame, of Ugandan organisation Straight Talk.

"In African culture, there was no use of condoms in the first place - so you cannot say it is against our culture," Dr Bagame said.

"However, when condoms first came to Africa it was the elite using them, and in most cases they used condoms in relationships that were not official. For official relationships they would not use condoms.

"It started from there - that if you are using condoms you are being promiscuous, and if you ask a man to use a condom it is a sign that you do not trust this man."

Sharing

Straight Talk has the objective of providing sex education to young people.

"Abstinence is the main method that we emphasise, but there are other methods... we are saying if you can't abstain, if you want 100% protection, please use a condom," Dr Bagame said.

He added that he would only recommend unprotected sex for married couples if both people had already been tested for HIV and other sexually-transmitted diseases.

But this was unlikely to happen among young Africans, and so alternative advice needed to be available, he said.

"The other alternatives go hand in hand with abstinence. Our understanding of abstinence is no sexual penetration.