Academic journal article Electronic Journal of Human Sexuality

Theoretical Assessment of University Condom Distribution Programs: An Institutional Perspective

Academic journal article Electronic Journal of Human Sexuality

Theoretical Assessment of University Condom Distribution Programs: An Institutional Perspective

Article excerpt

Introduction

Male condoms are commonly used by young adults and college students to prevent unintended pregnancy and sexually transmitted infections (STIs; American College Health Association [ACHA], 2013; Reece et al., 2010). According to a national assessment of condom acquisition patterns by men in the U.S., those who acquired free condoms received them from settings common to universities including health clinics (20.5%), health fairs (13.4%), dorms/student groups (13.4%), and classrooms (3.6%; Reece, Mark, Schick, Herbenick, & Dodge, 2010). Over the last 12 years, several empirical studies assessing sexual behaviors among students have identified condom errors and problems as important epidemiological risk factors (Crosby, Sanders, Yarber, & Graham, 2003; Crosby, Sanders, Yarber, Graham, & Dodge, 2002; Crosby, Yarber, Sanders, & Graham, 2004; Sanders et al., 2012; Yarber et al., 2007; Yarber, Graham, Sanders, & Crosby, 2004). Condom availability is an important contextual factor for condom use among adolescents (Boldero, Moore, & Rosenthal, 1992) and college students (Crosby et al., 2003; Crosby et al., 2002; Kashima, Gallois, & McCamish, 1993). A study conducted by Crosby and colleagues (2003) assessing condom use and condom-related problems among 158 college students found 42.4% of participants wanted to use a condom but did not have one available and 17.6% had a problem with a condom during sexual activity and did not have a secondary condom available.

Condom distribution programs are structural-level public health interventions that extend beyond the individual's personal risk by addressing access to condoms within given environments (Centers for Disease Control and Prevention [CDC], 2010). According to the CDC, wide-scale distribution is an important programmatic consideration for effective condom distribution interventions (2010). In the U.S., condom distribution programs have been used to increase availability in school settings (Blake et al., 2003; Guttmacher et al., 1997) and large-scale community-based distribution initiatives have been effective in increasing availability in New York City and Washington D.C. (CDC, 2010). A recent meta-analysis of 21 condom distribution programs by Charania and colleagues (2010) revealed significant intervention effects upon condom use, condom acquiring/condom carrying, delayed sexual initiation among youth, and reduced incidence of STIs. Additional findings indicated programs which incorporated individual and community-level considerations were more effective than those which only focused upon structural components. Various assessments have indicated condom distribution programs are cost effective (Bedimo, Pinkerton, Cohen, Gray, & Farley, 2002; Charania et al., 2010; Kirby et al., 1999; Schuster, Bell, Berry, & Kanouse, 1998).

The majority of colleges and universities in the U.S. distribute condoms to their student populations (Butler, Black, & Coster, 2011a; Eastmann-Mueller, Jung, Roberts, 2014; Koumans et al., 2005). Results of the ACHA 2013 Pap and STI Survey conducted by the ACHA (n = 140) indicated 87.9% of institutions distribute condoms to their students for free and 36.4% sell condoms on campus (Eastmann-Mueller et al., 2014). A national investigation of 736 schools by Koumans and colleagues (2005) revealed 52% of institutions distribute condoms to students, including 74% of schools with a health center. A recent assessment of 358 colleges and universities with student health centers by Butler and colleagues (2011a) indicated 84.9% of student health centers distribute condoms to students, with the mean of 9,414 condoms distributed/year. Select campus demographics have been found to significantly predict sexuality-related service availability at colleges and universities (Butler, Black, & Avery, 2012: McCarthy, 2002; Miller, 2011) including sponsoring of a condom distribution program (Butler et al. …

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