Abstract

BackgroundZimbabwe faces an uncertain future for condom funding and potential condom insecurity as international donors prioritize creating more self-sustaining markets and the government identifies how to best ensure access and uptake. We tested the impact of an intensive intervention on demand and supply after a price increase to the social marketed condom, Protector Plus. The study occurred during a deteriorating economy and pressure to reach sustainability quickly. We highlight where strategic donor investments can impact condom programming and markets.MethodsWe randomized ten purposively selected districts in Zimbabwe and assigned them to two study groups to test the impact of an intensive social marketing intervention. To the best of our knowledge, this is the first experimental study conducted within a larger market strengthening context. We tracked sales of Protector Plus and distribution of the public sector condom monthly. We conducted baseline and follow-up surveys among consumers and traders, and used the difference-in-difference method to test the intervention’s impact on condom preferences and brand equity.ResultsProtector Plus sales rebounded to previous levels after the price increase. We detected no significant difference in sales between the experimental and control districts. Among traders, there were no significant differences in brand preference for Protector Plus attributed to the intervention. Among consumers, there was a significant increase in emotional attachment and beliefs about condom efficacy in the experimental districts.DiscussionStudy findings demonstrate where international donor and government investments can impact condom programming and condom markets. Broader findings from the intervention highlight where investments can improve condom coverage, cost recovery, and collaboration between the public, social marketing, and commercial sectors. Strategic investments for strengthening condom markets include: consumer research to segment markets, willingness to pay studies to set price points, distribution system improvements to increase efficiency, intensive demand generation to increase demand and use, market facilitation across sectors, and market intelligence to inform decision making. When a disciplined social marketing approach is used, the market benefits: subsidies can be better targeted, branded products can appeal to the right audiences, and room can be made for the commercial sector to enter the market.

Highlights

  • In Zimbabwe, HIV prevalence is estimated to be 13.5% among men and women of reproductive age [1]

  • There were no significant differences in brand preference for Protector Plus attributed to the intervention

  • When a disciplined social marketing approach is used, the market benefits: subsidies can be better targeted, branded products can appeal to the right audiences, and room can be made for the commercial sector to enter the market

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Summary

Introduction

In Zimbabwe, HIV prevalence is estimated to be 13.5% among men and women of reproductive age [1]. Male condoms are an important part of the national HIV prevention strategy and Zimbabwe has historically had one of the strongest condom programs in the southern Africa region. There have been alarming trends in other risk behaviors, like the proportion of men reporting multiple sexual partners, which increased from 11% to 14% between 2010 and 2015 [6]. Trends like this highlight the need for consistent condom promotion and marketing to ensure that all high-risk sexual encounters are protected. We highlight where strategic donor investments can impact condom programming and markets

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