The fate of free male condoms distributed to the public in South Africa

Objectives: Public sector male condom distribution in South Africa rose fro m six million in 1994 to 198 million in 1999 as part of the government's co ndom promotion efforts for HIV/AIDS prevention. This study investigates wha t happens to the condoms which are distributed free of charge by the South African Department of Health. Methods: A prospective study was undertaken during 1998-1999 at 12 represen tative public health facilities. Five-hundred and fifty-four consecutive su bjects leaving the facilities were recruited and followed-up for 5 weeks to ascertain the fate of the 8164 condoms they had procured. Results: A total of 384 participants (69.3%) and their 5528 condoms (67.7%) were followed successfully. After 5 weeks, 43.7% of the condoms had been u sed or broken in sex, 21.8% had been given away, 8.5% had been lost or disc arded, acid 26.0% were still available for use. Increased rates of condom u se by participants were associated with active (compared to passive) condom procurement. Conclusions: In light of the rapidly increasing number of free condoms bein g distributed by the public health service in South Africa, it is reassurin g to note that wastage at 5 weeks is less than 10%. Extrapolating these dat a to the 198 million public sector condoms distributed in South Africa in 1 999, at least 87 million condoms were used in sex. This methodology may be used to help evaluate the impact of existing condom strategies. distributio n systems and the effectiveness of various condom promotion (C) 2001 Lippin cott Williams.