County Health Rankings & Roadmaps, A Healthier Nation, County by County

The County Health Rankings models and measures

Our Approach

The County Health Rankings model of population health

What can I do?

Action Center

Explore guides and tools for improving health.

What Works for Health

Explore programs and policies that work!

What can I learn from others?

Reports

Key findings from the last four years of County Health Rankings and other national reports.

County-by-County Blog

Project updates, commentaries, events and news about health across the nation from the County Health Rankings & Roadmaps team.

Condom availability programs

Condom availability programs provide condoms free of charge or at a reduced cost. Such programs can be implemented in a variety of settings.

Expected Beneficial Outcomes (Rated)

  • Increased condom use

  • Increased condom acquisition

Evidence of Effectiveness

There is strong evidence that condom availability programs increase condom acquisition and use (Charania 2011, ).

Community-based condom availability programs have been shown to increase condom use among adult males and high-risk populations such as men who have sex with men and commercial sex workers (Charania 2011). Distribution of free condoms by street outreach workers may increase condom use in high-risk populations (). Combining condom distribution programs with other interventions may have greater effects on condom use than distribution programs alone (Charania 2011).

School-based condom availability programs appear to increase condom acquisition among adolescents (Advocates for YouthBlake 2003Kirby 1999) and may also increase condom use (Advocates for YouthBlake 2003). Such programs have not been shown to change the frequency of sexual activity among students (Advocates for Youth, Kirby 1999).

Community-based free condom distribution programs may be more successful than subsidy programs, as cost is often a barrier to use (Cohen 1999). Additional characteristics of availability programs that may encourage acquisition of condoms include: providing assorted brands rather than single brand name condoms (Williams 2001) and engaging community businesses in high-risk areas or serving high-risk populations (, Renaud 2009, Cohen 1999).

Given the low cost of condoms and the potential benefits of use, free distribution programs are considered cost effective methods to increase condom use (Cohen 1999).

Impact on Disparities

No impact on disparities likely

Implementation Examples

More than 400 public schools in the US have made condoms available to students. NYC Condom is an example of a program that promotes condom use in a community setting. A 2009 evaluation indicates that the program’s web-based system is a key component of its success (Renaud 2009). 

Citations - Evidence

* Journal subscription may be required for access.

Advocates for Youth - Advocates for Youth. Rights. Respect. Responsibility.

Blake 2003 - Blake SM, Ledsky R, Goodenow C, et al. Condom availability programs in Massachusetts high schools: Relationships with condom use and sexual behavior. American Journal of Public Health. 2003;93(6):955-62.

Cohen 1999 - Cohen DA, Farley TA, Bedimo-Etame JR, et al. Implementation of condom social marketing in Louisiana, 1993-1996. American Journal of Public Health. 1999;89(2):204-8.

Williams 2001 - Williams JL, Christensen CJ, Cagle HH, Homan CE. Brief report on the effect of providing single versus assorted brand name condoms to hospital patients: A descriptive study. BMC Public Health. 2001;1(5).

Rovniak 2010* - Rovniak LS, Hovell MF, Hofstetter CR, et al. Engaging community business in HIV prevention: A feasibility study. American Journal Health Promotion. 2010;24(5):347-53.

Reece 2010* - Reece M, Mark K, Schick V, Herbenick D, Dodge B. Patterns of condom acquisition by condom-using men in the United States. AIDS Patient Care and STDs. 2010;24(7):429-33.

Renaud 2009 - Renaud TC, Bocour A, Irvine MK, et al. The free condom initiative: Promoting condom availability and use in New York City. Public Health Reports. 2009;124(4):481-9.

Kirby 1999 - Kirby D, Brener ND, Brown NL, et al. The impact of condom distribution in Seattle schools sexual behavior and condom use. American Journal of Public Health. 1999;89(2):182-7.

Charania 2011 - Charania MR, Crepaz N, Guenther-Gray C, et al. Efficacy of structural-level condom distribution interventions: A meta-analysis of US and international studies, 1998-2007. AIDS and Behavior. 2011;15(7):1283-97.

Denno 2012* - Denno DM, Chandra-Mouli V, Osman M. Reaching youth with out-of-facility HIV and reproductive health services: A systematic review. Journal of Adolescent Health. 2012;51(2):106–21.

Citations - Implementation Examples

* Journal subscription may be required for access.

Renaud 2009 - Renaud TC, Bocour A, Irvine MK, et al. The free condom initiative: Promoting condom availability and use in New York City. Public Health Reports. 2009;124(4):481-9.

NYC Condom - New York City Department of Health and Mental Hygiene (DOHMH). NYC condom.

Date Last Updated

Sep 10, 2014