Safe sex is a luxury as Lebanon's economy falters further

Walking into the supermarket, Reem* checks the prices of condoms discreetly as she scouts for the cheapest option.

"These prices are ridiculous! Almost 400,000 Lebanese Lira for 6 condoms from Durex!" she told The New Arab.

Reem has always been accustomed to buying the Durex brand for 20,000 L.L before the crisis due to its popularity and wide usage. However, she's now forced to prioritise price over preference. 

"I can't imagine spending 150,000 L.L on a cheap brand that I don't trust. I'd rather ask my friends for recommendations, otherwise, it is not worth it," Reem said.

"The crisis rendered imported birth control measures such as condoms, plan B, and contraceptive pills inaccessible"

Lebanon is almost three years into an economic and financial crisis that is among the worst the world had seen. The local currency has lost more than 90% of its value against the US dollar and the national poverty line is estimated to have risen by 9.1 percentage points by the end of 2021, according to a World Bank report.

The crisis rendered imported birth control measures such as condoms, plan B, and contraceptive pills inaccessible. Particularly to a population who doesn't enjoy access to US dollars. As a result, experts are warning of a sharp increase in sexually transmitted diseases (STDs) and sexually transmitted infections (STIs) if the situation persists as it is.

According to Ahmad*, a pharmacist in Beirut, medicines needed to treat STIs and STDs are not often found in pharmacies; patients are instead told to head to the Ministry of Health.

Plan B, on the other hand, is widely available but is sold at a staggering 500,000 L.L – while the minimum wage is only 675,000 L.L.

Maria*, a 26-year-old communication specialist, told The New Arab that she had reduced her sexual habits in half to decrease her expenses throughout the month. She notes that finding a discreet location had become also become a problem on its own.

"Many people still reside with their parents so my partners and I used to go for hotel rooms," she said. "But now we have to find the cheapest ones which are sometimes unsanitary and make me worry about infections."

Fearing pregnancies and unwanted abortions, Maria says sex seemed too stressful at times, especially if her partners weren't cooperative. She goes on to say that her previous partners were not fans of protection and would even argue with her over its necessity.

"This is why I always make sure to be the one buying the condoms. I know it might be costly in the long run, but it's a safer option than plan B or abortions," she said.

Although abortions are illegal in Lebanon, some doctors performed the procedures in secret with costs ranging between $300-$1,200, depending on the milieu of the operation; clinic, or hospital operating room.

The consequences of the illegal act varied from economic burdens and social labelling to severe medical complications such as haemorrhage and reproductive tract infections.

Based on her personal experience, Maria says that her female friends were the most concerned with safe sex, as men seemed dismissive of the importance of birth control and disease prevention.

Indeed, Andrew*, 26, told The New Arab that he is not in need of protection because "the expenses are not worth it when you know how to pull out".

"The local currency has lost more than 90% of its value against the US dollar and the national poverty line is estimated to have risen by 9.1 percentage points by the end of 2021, according to a World Bank report"

The stigma around sex in Lebanese society compounds the problem; sex education is left out of school curriculums and stigma takes severe forms for those suffering from HIV and AIDS.

According to Nadia Badran, executive director of SIDC – an NGO delivering sexual health services – the number of HIV/AIDS cases has doubled in the last three years. 

Running the risk of having unprecedented numbers of unwanted pregnancies and STIs, the country needs to act fast to prioritize sexual health, Nadia told The New Arab.

"Although we can provide free condoms and medical checkups, patients have to buy their own medicines and do additional tests in outside clinics and hospitals. This can be really costly and detrimental to their health if postponed," she said.

Chemsex or the use of recreational drugs such as mephedrone and crystal meth before or during sex has become an issue of its own, Nadia says. Once under the influence, preventive measures become difficult to adopt. 

Preliminary findings from a 2021 ongoing study, found that substance use has been increasing majorly in Lebanon, for those in need to induce sleep, self-medicate or control anxiety.

Nadia explains that taboo around sex makes it harder for people to seek help and head towards NGOs for advice and medical consultancy.

"There's a lot of mental health concerns within our youth. This is why it is an essential task to build spaces where young people can access services for their mental and sexual health, without feeling judged, condemned, or belittled," she said.

The LGBTQ+ community faces further condemnation as article 534 of the penal code criminalises LGBTQ+ people and allows for arbitrary detentions, government crackdowns, and non-consensual HIV tests.

Executive Director of LGBTQ+ advocacy NGO, Proud Lebanon, Bertho Makso told The New Arab that criminalising homosexuality installed shame and hesitance in those seeking free medical care services available in local NGOs such as Proud.

"We encourage people to turn to us for help but we know that changing the law will alleviate a lot of stress within the community; the conversation regarding safe sex and disease prevention will be made a lot easier," Bertho said.

Although the National AIDS Program distributes PrEP – the medicine taken to prevent getting HIV – for free, Bertho says that more is needed to help patients cover the costs of compulsory lab tests.

For this reason, Proud made arrangements with local labs to cut back the fees for members of the community and brought volunteer nurses to its centre, to protect their patients' identities.

"Our biggest issue is donations. We count on the Ministry of Health to help us because reproductive and sexual health is not a top priority to foreign donors. But we still need more help," Bertho concluded. 

Dana Hourany is a multimedia journalist based in Beirut