Meeting the Challenge: Promoting Use, Expanding Access, Ensuring Availability

Those providing information about HIV need to recognize that information alone does not necessarily translate into behavior change. To be effective, communications efforts must not only inform people about the risk of unsafe sexual behavior and the “ABCs of prevention” — abstinence, being faithful to one’s partner, and condom use — but also make the risks of unsafe sex look real to people. This “personalization” of risk motivates behavior change.

Programs must promote a range of safer sex behaviors in order to succeed. Uganda, by doing this, achieved a significant decrease in the number of non-regular partners (especially among those never married), and a reduction in the proportion of sexually active males among those aged 15-19. HIV prevalence in Uganda dropped significantly between 1994 and 1998 — from 21 to 10 percent among 15-49 year olds, and from 21 to 5 percent among 15-19 year olds.

Mass media support for condoms can be important in overcoming cultural resistance and changing societal norms. For example, an evaluation of a social marketing intervention in Paraguay, designed to increase the positive perception of condoms, showed increases in the proportion of girls who believe that it is responsible for them to suggest condom use to their partners.

Expanding Access

Increasing access to male and female condoms requires ensuring that condoms are in places where people can obtain them at a price they can afford — including, if necessary, free of charge. Strong coordination among all actors — donors, governments, and community stakeholders — can help maximize the use of available resources and the impact of activities. Market research can help determine the most appropriate condom promotion and distribution strategies for populations with varying needs.

Public sector and social marketing programs can channel free and subsidized condoms to the poor, while the private sector accommodates people who can afford to pay more for condoms. By limiting subsidies to those in need, market segmentation maximizes government and donor investments, freeing up funds for other strategies like programming to prevent commodity shortages. For example, a study completed by USAID’s Commercial Market Strategies (CMS) project reports that targeting the poor and needy could reduce government and donor costs by $8 million for condoms yearly by 2015.

Expanded use of social marketing can help with hard-to-reach and low-income groups. Diversifying points of distribution, including use of non-traditional outlets, can maximize the reach of prevention programs.

Ensuring Availability

Whether a country can make condoms available to its people also depends on a myriad of factors, in particular the availability of adequate financial resources and sufficient technical capacity in the areas of procurement and logistics.

Strong logistical systems are a prerequisite to the timely delivery, constant flow, and appropriate storage and shipping of high quality condoms.

The donor community must provide the necessary financial and technical resources to support the availability, accessibility, and quality of condoms.

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