People in South Africa have the highest rate of infection with HIV, the virus that causes AIDS, of any country in the world.  The South African government has recently enacted laws aimed at reducing the number of people with the infection. These laws include laws governing the distribution of condoms.  

Now a new study finds that the condom distribution laws - especially those allowing for condom distribution to adolescents - are creating a lot of public confusion.  Harvard University law student Juliana Han spent time in the South African state of KwaZulu Natal working with a nongovernmental organization called Mpilonhle, "a good life" in the local language. She says the prevalence of HIV is especially high among adolescents in KwaZulu Natal.

"Persons [age] 15 to 24 account for 34 percent of all new HIV infections," Han says. "In that same population, there's a prevalence of about 10 percent. So there's a very high prevalence already, but the more alarming figure is that this population is very much at risk for new infections of HIV."

A recent South African law says adolescents as young as 12 years old should be permitted to obtain condoms and creates penalties for those would deny condoms to adolescents. But Han points out that individual schools are permitted to decide whether or not to distribute them.

Han interviewed dozens of parents, educators and health officials. She held focus groups attended by hundreds of community members to get their thoughts about the condom distribution law. She was surprised at how emotional an issue condom distribution was among people who came to meetings. In her study, she reports attitudes of both people who want teens to have unlimited access to condoms and those who don't.

"There are a lot of people who say ? providing condoms will send the message to youth that we want them to be promiscuous, or it will encourage them to be so," Han says. "[This is] very much against a lot of the conservative tribal beliefs that are very strong in both the parents and the kids... And on the other side, the communities that we talked to were very aware of the danger, though? very much aware of the health threat."

Han found, in addition, many people didn't know what the laws were or misunderstood what they did say.   She also says parents need more education about HIV transmission and the role condoms play in stopping the spread of AIDS.

"Parents are very much not aware of the efficacy of condoms, how they work, why they're effective, when they're necessary, of course, and they're part of the program that encourages abstinence as the only foolproof method as of HIV prevention," Han says. "But there was a lack of understanding not only on HIV/AIDS? also how condoms work."

Han says the government needs to clarify the laws to reduce this confusion.  She also says parents and educators also need more education about HIV transmission.  She says this is more likely to happen under South Africa's new minister of health.

Han's paper is published in the online journal PLoS Medicine.