Bars, restaurants and stores in the archipelago of São Tomé and Príncipe now have a new attraction: small brown wooden boxes containing 144 condoms each, placed in highly visible locations. Condoms have traditionally been distributed at healthcare centres, but under the government's new prevention campaign they are gradually becoming more accessible.

"This is the way we came up with for condoms to be brought closer to São Tomeans," said Alzira do Rosário, coordinator of the National Programme for the Fight Against AIDS (known by the Portuguese acronym PNLS). "You don't have to ask anyone for anything - if you need one, all you have to do is take it."

The archipelago off the coast of Gabon, with some 160,000 inhabitants, has a seroprevalence of 1.5 percent, considered low on the continent. Nevertheless, health officials are concerned about the growing epidemic on the island.

"With every day that goes by, the situation becomes more complicated. AIDS is no longer a joke," warned Ângela Costa, coordinator of the Office for the Promotion of Women and Family at Manuel Quaresma Dias da Graça Costa Hospital, in a condom use promotion campaign.

Surprise

The initiative was launched by the PNLS in December 2007 on the island of Príncipe, where the boxes were placed in 34 strategic locations. The goal is to distribute 400 condom dispensers with the assistance of Alisei, an Italian non-governmental organisation (NGO). By December 2007 they had delivered 230 on the two islands.

In 2007, with financing from the Global Fund to Fight AIDS, Malaria and Tuberculosis, Alisei carried out the first-ever survey of the sex industry in São Tomé, interviewing a total of 120 people. Among the findings was a need for more places where condoms could be obtained, especially those open at night.

On a December afternoon, a pickup truck from Alisei entered the Benga neighbourhood on the outskirts of the city of Neves, 27km from the capital, São Tomé, with the condom boxes. One of the locations was the popular restaurant, Complexo Escala, where a poster advertising "Free condoms available here" was placed at the entrance.

The poster took a group of customers entering the restaurant for lunch by surprise. "This is great. Now, if we get ourselves a prostitute, we have condoms just one step away," public servant Leovigildo Bragança, 54, said jokingly. Restaurant owner Hélder Menezes told IRIN/PlusNews that he participated in the project "because this way I'm contributing to the fight against AIDS".

Alisei coordinator Mariangela Reina believes the initiative will also encourage women to become condom users. "Young people, especially, are embarrassed to go the pharmacy or health centre to get condoms. That's where the idea for the condom dispensers came from," she said.

The project has the support of the United Nations Population Fund, the US-based Global Fund to Fight AIDS, Tuberculosis and Malaria, and the São Tomé and Príncipe Federation of NGOs.

PNLS data from 2005 indicates that 95 percent of the population has knowledge regarding condom use, but only 45 percent use them in their sexual relations. The initiative hopes that by making condoms more readily available, this behaviour will change.