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

Abstract

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.

Understanding how social norms affect modern contraceptive use

“…Many public health interventions, such as social marketing interventions, have considerable experience in increasing the ability of target audiences to adopt new behaviors. They do so by providing practical solutions: subsidizing the price of contraceptives, making contraceptives widely available, and enabling couples to overcome the feeling of embarrassment when discussing contraceptive use with their partner [ 18 , 27 , 32 ]. If intervention designers were to assume that social norms influence contraceptive use through ability, the implications for program design may be very different than if they were to assume that social norms influence contraceptive use through motivation.…”

“…To operationalize the FBM, we identified survey items that were consistent with Fogg’s definition of motivation and ability. Concurrently, we reviewed the broader literature and identified motivation and ability factors that predict contraceptive use [ 22 – 32 ]. We then classified questions in the survey instrument into motivation or ability categories.…”

Understanding the Mechanism through Which Unfavorable Social Norms Affect Contraceptive Use 

“…Many public health interventions, such as social marketing interventions, have considerable experience in increasing the ability of target audiences to adopt new behaviors. They do so by providing practical solutions: subsidizing the price of contraceptives, making contraceptives widely available, and enabling couples to overcome the feeling of embarrassment when discussing contraceptive use with their partner [16,23,28]. Had we assumed that norms in uence contraceptive use through motivation, our conclusions and their implications for program design would have been very different.…”

“…To operationalize the FBM, we reviewed the survey instrument and identi ed survey items that were consistent with Fogg's de nition of motivation and ability. Concurrently, we reviewed the broader literature and identi ed motivation and ability factors that predict contraceptive use [18][19][20][21][22][23][24][25][26][27][28]. We then classi ed questions in the survey instrument into motivation or ability categories.…”

Chemsex Practices and Health-Related Quality of Life in Spanish Men with HIV Who Have Sex with Men

“…Although it is known that the previously explained phenomena could be the basis for the risk of transmission of HIV and other STDs in PLWHIV, in recent years, it has become clear that there is a need to identify other risky sexual behaviors that lead to a high probability of transmission of the virus. However, most studies focused on promoting the use of condoms and identifying the factors promoting their use, as shown in the review conducted by Evans [ 16 ]. Nevertheless, there is little research on newer sexual phenomena such as Chemsex.…”