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The goals of condom promotion and distribution are to: conduct activities at the individual, organizational, and community levels; increase condom use among persons with HIV infection and those at high risk of acquiring HIV and other sexually transmitted infections (STI); and integrate targeted condom distribution activities into appropriate HIV prevention activities. Persons at high risk of acquiring HIV and STI include men who have sex with men (MSM), injection drug users (IDU), and high-risk heterosexual African Americans (HRHAA).
Agencies implementing condom promotion and distribution programs are required to address one or more of the following in their communities:
- Condom availability;
- Condom accessibility; and
- Condom acceptability.
Condoms purchased by the Department of State Health Services (DSHS) or with DSHS funds may not be used for resale purposes and must be offered to the community at no cost. Agencies must develop policies and procedures for conducting condom promotion and distribution activities.
5.1 Reaching Multiple Levels
Traditionally, condom distribution and promotion efforts have been conducted at the individual level (during outreach, testing, and special events). DSHS expects agencies to have activities focused on several levels of the Socio-Ecological Model (SEM) as shown.
The following is a list of resources to assist with the development of effective interventions to increase condom distribution beyond the individual level.
CDC Division of HIV/AIDS Prevention:
Condom Distribution as a Structural Level Intervention
Effective Interventions:
HIV Prevention that Works
Structural Interventions:
Condom Distribution Programs
New York City Department of Health and Mental Hygiene:
Condom Program
Philadelphia Department of Health:
Take Control Philly
The District of Columbia Department of Health:
Free Condoms for DC
5.2 Community Assessment
Agencies funded for condom distribution are required to conduct an initial assessment of their community to determine condom availability, accessibility, and acceptability. Once the initial assessment is conducted, agencies are required to conduct ongoing assessments and integrate data from assessments to determine changes that may have occurred in the community. Agencies will make changes to their promotion and distribution programs accordingly.
DSHS recommends that community assessments answer the following questions:
- Who are you trying to reach with your condom distribution program?
- How will you increase the availability, accessibility, and acceptability of condom use?
- What supplies will you distribute in your condom distribution program (e.g., condoms, lube, pamphlets)?
- Where will your condom distribution program activities take place?
An Introduction to Community Assessment Tools can be found on DSHS website:
dshs.texas.gov/hivstd/fieldops/CommAssess.shtm
5.3 Condom Distribution Sites
Condom distribution sites are required to increase condom availability, accessibility, and acceptability. It is required that condoms be distributed at no cost to high-risk sexually active individuals and persons who inject drugs (PWID) through pre-approved distribution sites. Distribution sites shall be located in high-risk target areas. Site location shall relate to the morbidity in the community and the frequency with which individuals from the high-risk populations go to the distribution site.
5.3.1 Best Practices
DSHS considers the following activities, approaches, and strategies as best practices for agencies implementing condom distribution activities. These items are not contractual requirements. However, these practices may lead to better condom distribution and promotion outcomes.
- Condoms should be visibly and openly accessible to clients such as:
- On a counter;
- In an open container; or
- In a clear plastic, or glass container.
- Advertising to promote distribution and usage of condoms using:
- Signs and posters;
- Print materials; and
- Websites.
5.3.2 Screening
Sites requesting condoms should have the capacity to display and distribute condoms at no cost, be located in a high-morbidity area and interact with individuals with HIV or at risk of acquiring HIV/STI. DSHS recommends agencies screen sites prior to providing them with condoms to ensure they meet the above criteria.
DSHS also recommends agencies create an instrument to document distribution site information. This instrument should collect:
- Name;
- Address;
- Phone number;
- Site contact;
- Number of condoms requested; and
- Type of condoms requested.
Agencies can obtain sample forms by contacting their DSHS Prevention Consultant.
5.3.3 Site Visits
A physical, on-site visit to verify the site’s type of business, clientele, and high-risk criteria is recommended when screening a potential site. The date of the visit and the name of the person conducting the visit should be documented.
A site visit is encouraged for:
- Any new site interested in participating in the condom distribution program;
- Any site mentioned in a complaint;
- Any site that has previously participated in the condom distribution program but has been inactive longer than 6 months; and
- Any site that has a change of address.
Once the agency has screened a site and determined that the site is appropriate, the condom distribution site shall be provided with the agency’s name, phone number, and website (optional) so sites may call the agency to replenish their supplies as needed. It is the responsibility of the agency to monitor and replenish each site’s supplies. Agencies are encouraged to provide prevention materials (brochures, posters, stickers, etc.) to each site.
5.3.4 Maintaining and Monitoring
Each condom distribution site is to be monitored by the assigned agency at the agency’s discretion to ensure: sites have an adequate supply of materials (that are not expired), and supplies are easily visible and accessible to clientele. On-site visits of condom distribution sites should be documented. Additional follow-up contacts may be made by telephone or email.
All condom distribution activities, number of condoms distributed (both to distribution sites and individuals), site visits, and interactions with collaborators will be documented and reported to DSHS in the approved DSHS format. For more information regarding reporting formats, agencies should contact their DSHS Prevention Consultant. Monitoring documents for condom distribution activities shall be made available to DSHS upon request.
5.4 Ordering Prevention Materials
Agencies will be required to obtain condoms through their own means. This can be accomplished by ordering condoms through a vendor of their choice using funds negotiated in their HIV Prevention budget. Agencies can also order select condoms at no cost through DSHS. Condom supply and number is limited and may vary based on available funding. Agencies may contact their DSHS Prevention Consultant for more information about ordering condoms through DSHS.
Additional prevention materials, including posters and brochures, can be ordered through the DSHS website:
HIV and STD Educational Materials.
5.5 Collaborators
Agencies are required to collaborate with community members, venues, and organizations to increase condom distribution and promotion. Collaborators’ involvement may vary and could include any or all of the following activities.
Distributing Materials - Distributing condoms and other HIV prevention materials for a funded agency.
Advocating - Promoting, advertising, or referring the community to condom distribution sites.
Volunteering - Freely participating in a funded agency’s distribution or promotion efforts.
Donating - Donating materials, supplies, money, time, or space to a funded agency.
Improving Access - Improving condom access by removing potential barriers (e.g., a pharmacy makes condoms easier for customers to access).
5.6 Additional Best Practices
Agencies implementing condom distribution are encouraged to use the following activities, approaches, and strategies. Although not a contractual requirement, these best practices may lead to better condom distribution and promotion outcomes.
- Distribute condoms to individuals who are HIV-positive(e.g., during outreach to individuals at risk for acquiring HIV/STI, during HIV testing and counseling sessions, and (as appropriate) during all other HIV prevention activities);
- Design and implement local social marketing campaigns to promote acceptance of condom use;
- Work with local vendors (e.g., pharmacies, storefronts) to ensure condoms are accessible (e.g., not behind a locked cabinet); and
- Access clients or potential clients through a variety of channels, including the internet. Funded agencies are encouraged to use technology such as internet dating sites, social network media (e.g., Twitter), and other internet-based methods to access priority populations.
5.7 List of Helpful Websites and Websites Referenced in Chapter 5
Information regarding Community Assessment Tools can be found at the following DSHS website:
dshs.texas.gov/hivstd/fieldops/CommAssess.shtm
Information regarding prevention materials can be found at the following DSHS website:
dshs.texas.gov/hivstd/info/edmat.shtm
Centers for Disease Control and Prevention:
cdc.gov
Health and Safety Code:
statutes.legis.state.tx.us/?link=HS
Texas Constitution and Statutes:
statutes.legis.state.tx.us/?link=HS
Texas Family Code:
statutes.legis.state.tx.us/?link=HS
U.S. Code:
law.cornell.edu/uscode/text |