Condom availability programs

There is strong evidence that condom availability programs increase condom acquisition and use^{3, 4, 5}.

Community-based condom availability programs have been shown to increase condom use among adult males and high-risk populations such as commercial sex workers, individuals with many sexual partners, and people living in areas with a high incidence of sexually transmitted infections (STIs)⁵. Condom distribution interventions may reduce risky sexual behaviors in adults, such as condomless sex⁴, and distribution of free condoms by street outreach workers may increase condom use in high-risk populations⁶.

School-based condom availability programs increase condom acquisition among adolescents^{3, 7}. The Society for Adolescent Health and Medicine recommends condom availability in schools to increase their use⁸, although available evidence indicates program effects on condom use may be mixed^{3, 7}. Such programs have not been shown to change the frequency of sexual activity among students or increase other risk behaviors^{3, 7}, and may delay sexual initiation⁵.

Combining condom distribution programs with other interventions may have greater effects on condom use than distribution programs alone⁵. A study of a program at a historically black college suggests that availability of free condoms from condom dispensers featuring point of access messaging may increase condom use among the black women using the dispensers⁹. The Women’s Fund of Omaha developed a youth-focused condom initiative, distributing free condoms via outreach events and condom distribution boxes while implementing seven media campaigns encouraging condom use, increasing condoms distributed per month from 9,840 in September 2015 to 71,220 in February 2018¹⁰.

Experts recommend providing a variety of condom styles and brands, including the most sought-after brands, and related information as a strategy to increase use among high-risk populations¹¹. Engaging community businesses in high-risk areas or serving high-risk populations as distribution sites can increase acquisition of condoms^{12, 13, 14}; however, ensuring quality control and keeping sites adequately supplied can present challenges to planners. Web-based and site-based distribution can be done together, but experts recommend planners have sufficient resources available to meet demand, especially potential surges in online ordering¹.

Free condom distribution programs may be more successful than subsidy programs, as cost is often a barrier to use. Given the low cost of condoms and the potential benefits of use, free distribution programs are considered cost-effective methods to increase condom use¹⁵.

A recent survey of condom distribution program planners found networks for site-based distribution had 100 to 3,500 sites in various jurisdictions; an examination of total supplies distributed, including male condoms, internal condoms, and lubricants, showed smaller programs distributing 16,000 per year, while larger programs provided up to 45 million per year¹.

The NYC Condom Availability Program is an example of a program that promotes condom use in community settings¹⁶. The Condom Fairy program at Boston University is an example of a mail order delivery program on a college campus¹⁷.