An intervention study examining the effects of condom wrapper graphics and scent on condom use in the Botswana Defence Force

Abstract

Free condoms provided by the government are often not used by Botswana Defence Force (BDF) personnel due to a perceived unpleasant scent and unattractive wrapper. Formative work with the BDF found that scented condoms and military inspired (camouflage) wrapper graphics were appealing to personnel. A non-randomized intervention study was implemented to determine if condom wrapper graphics and scent improved condom use in the BDF. Four military sites were selected for participation. Two sites in the south received the intervention condom wrapped in a generic wrapper and two sites in the north received the intervention condom wrapped in a military inspired wrapper; intervention condoms were either scented or unscented. 211 male soldiers who ever had sex, aged 18–30 years, and stationed at one of the selected sites consented to participate. Sexual activity and condom use were measured pre- and post-intervention using sexual behavior diaries. A condom use rate (CUR; frequency of protected sex divided by total frequency of sex) was computed for each participant. Mean CURs significantly increased over time (85.7% baseline vs. 94.5% post-intervention). Adjusted odds of condom use over time were higher among participants who received the intervention condom packaged in the military wrapper compared with the generic wrapper. Adjusted odds of condom use were also higher for participants who reported using scented versus unscented condoms. Providing scented condoms and condoms packaged in a miltiary inspired wrapper may help increase condom use and reduce HIV infection among military personnel.

Patterns and Determinants of Consistent Condom Use Among Cameroonian Soldiers

“…Alcohol use (37.5%) and trust in sexual partners (37%) were cited as the common reasons why respondents found condom use unnecessary. Tran et al reported similar findings from Botswana (18). Over 70% of the respondents reported that intercourse with condoms was not enjoyable.…”

“…A pilot study in Botswana showed that providing scented condoms and condoms packed in a militaryinspired wrapper may help to increase condom use and reduce HIV infection among military personnel (18). Bing et al in a study on Angolan soldiers showed increased condom use, reduced unprotected vaginal sex, and reduced numbers of partners after a training and prevention intervention (21).…”

“…In Botswana, scented condoms and condoms packed in military wrappers improved condom use among the soldiers (18). In Belize, alcohol abuse was prevalent and associated with HIV risky behaviors (19).…”

Female condom color and scent preference in Durban, South Africa

“…The smell and color of latex condoms are unattractive to many users [2] , [3] ; however, both these features—scents (masked by flavored and/or scented lubricants) and pigments—are available that are compatible with condoms, and do not affect their structural integrity (strength) [4] , [5] . Although colored and scented male condoms have been available for many years [1] , colored and scented female condoms (FCs) were not available globally until 2019.…”

“…Limited data exist on preferences for the scent and color of male condoms [2] . No data exist on user preferences for FC scent and color.…”