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AIDS. 2011 Jan 14;25(2):247-55. doi: 10.1097/QAD.0b013e328341b9b8.

Exploring the condom gap: is supply or demand the limiting factor - condom access and use in an urban and a rural setting in Kilifi district, Kenya.

Author information

  • 1Department of Public Health, University of Oxford, Headington, UK. jacqueline.papo@gmail.com

Abstract

OBJECTIVE:

to explore the extent of the condom gap, investigating the relative roles of supply-side and demand-side factors in determining condom use.

DESIGN:

GPS mapping of condom outlets, and population-based survey.

METHODS:

an urban and a rural site were selected within the Epidemiological and Demographic Surveillance Site in Kilifi district, Kenya. Potential condom outlets (n = 281) were mapped and surveyed, and questionnaires on condom access and use (n = 630) were administered to a random sample of men and women aged 15-49. Multivariate logistic regression was performed to assess the relative roles of supply-side and demand-side barriers on condom use.

RESULTS:

the median straight-line distance to free condoms was 18-fold higher in the rural versus urban site. Among sexually active respondents, 42% had ever used a condom, and 23% had used a condom over the past 12 months, with lower levels among rural versus urban respondents (P < 0.05). The mean number of condoms used was 2.2/person per year among all sexually active individuals (condom users and nonusers), amounting to 8.2% protected sex acts/person per year. The adjusted odds of condom use (past 12 months) were 8.1 times greater among individuals experiencing no supply-side or demand-side barriers, compared with individuals experiencing both types of barriers. Despite low levels of usage and the presence of supply-side and demand-side barriers, reported unmet need for condoms was low.

CONCLUSIONS:

there is an urgent need for renewed condom promotion efforts aimed at building demand, in addition to improving physical access, in resource-limited settings with generalized HIV epidemics in sub-Saharan Africa.

2011 Wolters Kluwer Health | Lippincott Williams & Wilkins.

PMID:
21150559
[PubMed - indexed for MEDLINE]
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