Saturday 23 Feb 2019 | 14:43 | SYDNEY
Saturday 23 Feb 2019 | 14:43 | SYDNEY

Zen and the art of condom distribution

4 December 2009 13:19

Dr Rod Nixon is an Adjunct Research Fellow at Charles Darwin University, and Dr Charles Eaton is Foundation Fellow, Institute of Regional Development, UWA.

Can market networks provide an answer to condom distribution in weak HIV-vulnerable states?

In its 2004 Position Statement, UNAIDS recognised the male latex condom as 'the single, most efficient, available technology to reduce the sexual transmission of HIV and other sexually transmitted infections'. UNAIDS noted that insufficient numbers of condoms were being distributed in low-income and middle-income countries, and emphasised that '(c)ondoms must be readily available universally, either free or at low cost, and promoted in ways that help overcome social and personal obstacles to their use'.

Despite advances, realising and sustaining universal access to condoms is an ongoing challenge. Many of the countries affected by high rates of HIV infection or vulnerable to HIV transmission are weak states with fragile distribution networks, weather-prone infrastructure and unreliable access to vehicles and fuel. Donor support programs, meanwhile, can be sporadic.

Accordingly, the supply of condoms faces formidable bottlenecks. The extent of the challenge is demonstrated by a case earlier this year, where the PNG Defence Force assisted delivery, at least to the provincial level, of 43 million condoms reportedly provided with Australian aid assistance.

Unlike programs on HIV/AIDS awareness and condom use, which can be undertaken as logistical considerations permit, the distribution of condoms must occur on a permanent, sustainable and uninterrupted basis. In an effort to address this challenge, we are seeking support for a trial implementation and evaluation of a program aimed at distributing condoms to the village kiosk and roadside stall level of HIV-vulnerable weak states using 'companion product' packaging.

The objective is to attach condoms, in the factory, to a range of widely consumed products distributed to the periphery of the economies of HIV-vulnerable weak states (including sub-Saharan African states, PNG and Timor-Leste) using market networks. Products being considered include soap, telephone cards, razor blades and cigarettes (pictured).

The use of tobacco products, despite their known health risks, is proposed because of the level of consumption of cigarettes and the serious nature of the epidemic. From a harm-minimisation perspective, smoking is bad, but smoking and practising unsafe sex is worse. 

Distributing condoms using 'companion product' packaging has the potential to (a) overcome distribution challenges, thereby contributing to both HIV/AIDS prevention and family planning objectives in weak states; (b) reduce stigma associated with purchasing condoms in the village and settlement, since the purchase of the condom will be masked in the purchase of the companion product; and (c) contribute to the normalisation of condoms in the community.

We have already begun identifying manufacturers/distributors prepared to pioneer this concept, but still need condoms supplies to implement a trial in four high-risk countries.