Early in the course of the AIDS epidemic, condoms were recognized as an effective means of prevention if used properly and consistently. All the European countries from which data are presented in this chapter have included the promotion of condom use in their overall AIDS prevention policies, even if the importance of this element in relation to others, such as promotion of counselling and testing and advocacy of fidelity, has differed according to the different socio-cultural and political contexts. Prevention campaigns addressing the general population have been used more or less extensively, differing in intensity, duration, tone and style (Wellings, 1994), but were present in all countries.
In our comparison of condom use in the various countries, it is important to remember that attitudes to condoms at the beginning of the AIDS epidemic differed from country to country. Condoms have a long history: the first published mention of the device dates back to 1564. Although originally intended for disease prevention, their contraceptive properties were already known in the eighteenth century. The discovery of the vulcanization of rubber in 1839 led to widespread potential availability of the product (Gerofi and Spencer, 1994). However, traditions of use vary considerably from country to country (see Table 9.1), being determined by specific social, political and commercial environments. In some countries, such as the UK, they were for a long period the principal means of contraception, and were obtained both commercially and in birth control clinics. In others, their use was historically much more limited. In France, for example, they suffered from restrictions similar to those imposed on other contraceptive methods until 1967, when birth control finally became officially available. Furthermore, legislation prohibiting their promotion for disease prevention and for contraception was not finally abolished until 1987 and 1991 in the UK and France respectively.