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.
Highlights
Despite gains made in the prevention of HIV and the scaling up of treatment programs, incidence is still alarmingly high in some settings
The articles dealt with interventions relating to social marketing and promotion of condom brands, HIV/sexually transmitted infections (STIs) prevention programs based on increasing condom use, and family planning programs that promoted condoms
This study demonstrates that condoms continue to be widely promoted worldwide and, given the epidemiology of HIV/STIs, they remain a crucial technology for preventing transmission
Summary
Despite gains made in the prevention of HIV and the scaling up of treatment programs, incidence is still alarmingly high in some settings. An estimated 1.7 million people were newly infected in 2018, with an unmet need for contraception of some 214 million individuals and 357 million cases of curable sexually transmitted infections (STIs) [2]. Donor funding for condom programs is a concern; global investments in HIV prevention have declined 44% since [4]. Intensified efforts are urgently needed to increase condom use, especially in high HIV/STI prevalence countries. 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. Results: Condom promotion programs were generally effective in changing attitudes, social norms, and beliefs in favor of condom use, and 85%
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