Condom availability programs

Condom availability programs provide condoms free of charge, usually through events, community and school site-based distribution, and web-based mail order. Programs use social marketing campaigns to inform potential users about where and how condoms can be accessed. Programs are typically run by health departments and community-based organizations (). When implemented at the structural level, condom distribution programs should ideally include not just wide-scale distribution and social marketing campaigns, but also community-wide mobilization to promote condom use, additional risk reduction interventions, and work with both traditional and non-traditional venues. These promotion and distribution efforts should be conducted at the individual, organizational, and environmental levels (CDC-CDPs).

Expected Beneficial Outcomes (Rated)

  • Increased condom use

  • Increased condom acquisition

Other Potential Beneficial Outcomes

  • Decrease risky sexual behavior

  • Reduced incidence of STIs

Evidence of Effectiveness

There is strong evidence that condom availability programs increase condom acquisition and use (Wang 2018b, Malekinejad 2017, Charania 2011).

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) (Charania 2011). Condom distribution interventions may reduce risky sexual behaviors in adults, such as condomless sex (Malekinejad 2017), and distribution of free condoms by street outreach workers may increase condom use in high-risk populations ().

School-based condom availability programs increase condom acquisition among adolescents (, Wang 2018b). The Society for Adolescent Health and Medicine recommends condom availability in schools to increase their use (), although available evidence indicates program effects on condom use may be mixed (, Wang 2018b). Such programs have not been shown to change the frequency of sexual activity among students or increase other risk behaviors (, Wang 2018b), and may delay sexual initiation (Charania 2011).

Combining condom distribution programs with other interventions may have greater effects on condom use than distribution programs alone (Charania 2011). 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 dispensers (Francis 2018). 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 2018 ().

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 populations (). Engaging community businesses in high-risk areas or serving high-risk populations as distribution sites can increase acquisition of condoms (Rovniak 2010, Renaud 2009, Cohen 1999); 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 ordering ().

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 use (Cohen 1999a).

Impact on Disparities

Likely to decrease disparities

Implementation Examples

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 year ().

The NYC Condom Availability Program is an example of a program that promotes condom use in community settings (NYC Condom). The Condom Fairy program at Boston University is an example of a mail order delivery program on a college campus (Butler 2018).

Implementation Resources

AFY-Condom Collective - Advocates for Youth (AFY). The Condom Collective.

CDC-Condom distribution - Division of HIV/AIDS Prevention (DHAP), National Center for HIV/AIDS, Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention (CDC). Condom distribution as a structural level intervention.

CDC-CDPs - Centers for Disease Control and Prevention (CDC). HIV: Condom distribution as a structural level intervention.

Maziarz 2017 - Maziarz L. Breaking down the administrative barriers: Condom availability in the school setting. NASN School Nurse. 2018;33(2):110-114.

Citations - Evidence

* Journal subscription may be required for access.

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.

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.

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.

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.

McCool-Myers 2019* - McCool-Myers M. Implementing condom distribution programs in the United States: Qualitative insights from program planners. Evaluation and Program Planning. 2019;74:20-26.

Wang 2018b - Wang T, Lurie M, Govindasamy D, et al. The effects of school-based condom availability programs (CAPs) on condom acquisition, use and sexual behavior: A systematic review. AIDS and Behavior. 2018;22(1):308-320.

Malekinejad 2017 - Malekinejad M, Parriott A, Blodgett JC, et al. Effectiveness of community-based condom distribution interventions to prevent HIV in the United States: A systematic review and meta-analysis. Public Library of Science (PLoS) ONE. 2017;12(8):e0180718.

Wendell 2003* - Wendell DA, Cohen DA, LeSage D, et al. Street outreach for HIV prevention: Effectiveness of a state-wide programme. International Journal of STD and AIDS. 2003;14(5):334-340.

Andrzejewski 2019* - Andrzejewski J, Liddon N, Leonard S. Condom availability programs in schools: A review of the literature. American Journal of Health Promotion. 2019;33(3):457-467.

SAHM 2017* - The Society for Adolescent Health and Medicine. Condom availability in schools: A practical approach to the prevention of sexually transmitted infection/HIV and unintended pregnancy. Journal of Adolescent Health. 2017;60(6):754-757.

Francis 2018 - Francis DB, Noar SM, Fortune DA, et al. “Be straight up and so will he”: Evaluation of a novel HIV prevention condom distribution and health communication intervention targeting young African American females. AIDS Education and Prevention. 2018;30(2):137-151.

Tibbits 2018* - Tibbits M, Ndashe TP, King K, et al. Promoting condom use through a youth-focused community-wide free condom distribution initiative. American Journal of Public Health. 2018;108(11):1506-1508.

Cohen 1999a - Cohen D, Scribner R, Bedimo R, et al. Cost as a barrier to condom use: The evidence for condom subsidies in the United States. American Journal of Public Health. 1999;89(4):567-568.

O’Neal 2015* - O’Neal JD, Berteau LC. Revitalizing condom-centered HIV prevention strategies. Current HIV/AIDS Reports. 2015;12(1):139-144.

Citations - Implementation Examples

* Journal subscription may be required for access.

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

McCool-Myers 2019* - McCool-Myers M. Implementing condom distribution programs in the United States: Qualitative insights from program planners. Evaluation and Program Planning. 2019;74:20-26.

Butler 2018 - Butler SM, Mooney K, Janousek K. The Condom Fairy program: A novel mail-order service for condoms and sexual health supplies. Journal of American College Health. 2018:1-9.

Date Last Updated

Sep 26, 2019