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By Giff Johnson

MAJURO, Marshall Islands (Marianas Variety, Aug. 21) — The virtually non-existent use of condoms in the Marshall Islands is being called a "potentially dangerous situation" by government officials faced with the Pacific region’s highest teen pregnancy rate and high rates of sexually transmitted diseases.

The lack of condom use may also force health officials to dump thousands of donor-donated condoms that will expire in January.

A Marshall Islands government report on the state of health services in this central Pacific nation says there is a continuing high rate of sexually transmitted diseases — particularly syphilis. But the report also raises the disturbing finding that many of the STDs are not being found at an early stage, leading to more health complications — and costs to the government — for treatment.

"Discussions with health providers indicate that many people do not get tested until the later stages of the diseases when symptoms are more noticeable, and in some instances, at a point where it is no longer treatable," the report issued Friday says. "Or in the case of chlamydia, women find that they are infertile and/or have severe abdominal pain and infections, often leading to a hysterectomy."

The Ministry of Health reports that in 2004, a total of 6.1 percent (288) of 4,075 people tested were found positive for syphilis. This is considered a high rate of the sexually transmitted disease.

Two new HIV-positive cases were confirmed recently, bringing to three the documented number of HIV-positive islanders. Although the HIV numbers remain relatively low, it is providing little comfort to health providers who are only too aware of the linkage between high syphilis rates and HIV infection.

The increasing number of sexually transmitted diseases are caused, in part, by very low condom use in the country, the government report says.

The Marshall Islands also has the highest rate of teen pregnancy in the region. Last year, teenagers accounted for more than 17 percent of all live births in the Marshall Islands.

The report also comments on the nearly complete lack of participation by men in reproductive health and condom use. Only 63 men went to the Reproductive Health Clinic at Majuro Hospital in four years from 2001-2004. The report says this information suggests that "the main burden of family planning and reproductive health is on the female, with few or no males taking responsibility for preventing pregnancy."

In addition, of the mostly female 1,479 contraceptive users in 2004, only 15 percent used condoms. What this means, the report says, is that the vast majority of people using contraceptives are using methods "that did not prevent transmission of sexually transmitted diseases."

Meanwhile, with condom use relatively low, thousands of condoms provided by international donors are currently going unused and, according to health officials, will reach their expiration safety date in January.

August 21, 2005

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