Systematic Review of Peer-Reviewed Literature on Global Condom Promotion Programs.

Background: Globally, 1.7 million people were newly infected with HIV in 2018. Condoms are inexpensive, cost-effective, reduce HIV/STI incidence, morbidity, mortality, and unintended pregnancies, and result in health care cost savings. Given the rapid increase in at-risk adolescent and young adult (AYA) populations in countries with high HIV/STI prevalence as well as the reductions in donor support, promoting consistent condom use remains crucial. We synthesized all peer-reviewed literature on condom promotion programs with a focus on promotion in low and lower middle income (LMIC) countries and with AYA users. Methods: We systematically reviewed the published literature. Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) methods, we identified 99 articles published between 2000-2019. Results: Condom promotion programs were generally effective in changing attitudes, social norms, and beliefs in favor of condom use, and 85% demonstrated positive effects on multiple condom use measures. Programs targeting AYA were at least equally as effective as those targeting others and often showed greater use of best practices, such as mass media (66%) and audience segmentation (31%). We also saw differences between programs in the intervention strategies they used and found greater effects of marketing strategies on AYA compared to the overall sample. Conclusion: Condoms remain essential to prevention, and donor support must be maintained to combat the HIV/STI epidemic.

Willingness to Pay for Condoms among Men in Sub-Saharan Africa.

HIV/AIDS and other sexually transmitted infections (STIs) continue to be among the greatest public health threats worldwide, especially in sub-Saharan Africa (SSA). Condom use remains an essential intervention to eradicate AIDS, and condom use is now higher than ever. However, free and subsidized condom funding is declining. Research on how to create healthy markets based on willingness to pay for condoms is critically important. This research has three primary aims: (1) willingness of free condom users in five African countries to pay for socially marketed condoms; (2) the relationship between specific population variables and condom brand marketing efforts and willingness to pay; and (3) potential opportunities to improve condom uptake. Nationally representative samples of at least 1200 respondents were collected in Kenya, Nigeria, South Africa, Zambia, and Zimbabwe. We collected data on a range of demographic factors, including condom use, sexual behavior, awareness of condom brands, and willingness to pay. We estimated multivariate linear regression models and found that free condom users are overwhelmingly willing to pay for condoms overall (over 90% in Nigeria) with variability by country. Free users were consistently less willing to pay for condoms if they had a positive identification with their free brand in Kenya and Zimbabwe, suggesting that condom branding is a critical strategy. Ability to pay was negatively correlated with willingness, but users who could not obtain free condoms were willing to pay for them in Kenya and Zimbabwe. In a landscape of declining donor funding, this research suggests opportunities to use scarce funds for important efforts such as campaigns to increase demand, branding of condoms, and coordination with commercial condom manufacturers to build a healthy total market approach for the product. Free condoms remain an important HIV/AIDS prevention tool. Building a robust market for paid condoms in SSA is a public health priority.

News media tracking of tobacco control: a review of sampling methodologies.

News media tracking can be used to understand the content of news coverage and quantify its influence on public opinion and the social environment. We hypothesize that a parsimonious sampling of public health news coverage can gather statistically equivalent information to capture a census of coverage. We tested two general approaches to sampling. First, we randomly selected articles within a timeframe. Second, we randomly selected dates during 2000. None of these strategies showed a substantial deviation from the 2000 census of articles. We conclude that sampling coverage can produce estimates statistically equivalent to a census. Researchers should utilize coverage sampling.

Adult and group influences on participation in youth empowerment programs.

This study examined adult and group influences on youth participation in youth empowerment (YE) Statewide Youth Movement Against Tobacco Use programs. Adults provide individual guidance to youth groups and through existing tobacco control networks affect the social context in which YE programs are implemented. The authors tested hypotheses about the direct and indirect relationships between adults, groups, and youth collective participation. They used data from adults and youths to develop a measurement model of four higher order factors: adult involvement, group structure, group climate, and collective participation. They tested relationships between these factors in a structural equation model. Results showed that adult involvement did not have a meaningful direct effect on group factors or collective participation. Group factors mediated the relationship between adult involvement and collective participation. Further research is needed on how to measure adult involvement and its relationship to youth participation.