Understanding constraints to adolescent condom procurement: the case of urban Botswana

Even when condoms are widely available and affordable, adolescents may be r eluctant to obtain them. Hence, programme managers need to understand what determines youths' perceptions of access to condoms. This paper analyzes fo cus group and survey data on condom access conducted among male and female adolescents in urban Botswana. Although a majority of sexually experienced adolescents have purchased condoms from retail outlets, only about 50% have obtained condoms from health facilities, even though the latter distribute free condoms. This study shows that many adolescents perceive that access to condoms is more difficult from public sector outlets than for private se ctor outlets, because the public sector providers tend to question the adol escents' behaviour while the latter do not. To bypass this problem, males t end to obtain condoms from friends. However, females are reluctant to ask t heir friends for condoms because they fear that their friends may gossip ab out them. The results of this study indicate that adolescents' access to co ndoms can be improved by interventions that improve the quality of interact ion between public sector providers and adolescents, destigmatize condom us e, expand private sector condom distribution, and that use peer sales agent s and educators.