Assessment of university condom distribution programs: results of a national study.

Author:Butler, Scott M.


Male latex condoms have been found to significantly reduce the risk of sexually transmitted infections (STIs; Ahmed et al., 2001; Bleeker et al., 2003; CDC, 2012; Hogewoning et al., 2003; Holmes, Levine, & Weaver, 2004; Sanchez et al., 2003; Winer, 2006) and unintended pregnancy (Trussell, 2007). Results of the spring 2012 American College Health Association (ACHA): National College Health Assessment II survey revealed that 59.6% of sexually active college students used a male condom the last time they had vaginal intercourse, .6% a female condom, and 45.3% report using a male condom in addition to another method (ACHA, 2013). Lack of availability of condoms has been reported as a barrier to condom use among college students (Crosby et al, 2003; Crosby et al., 2002). Condom distribution programs are one form of public health structural interventions designed to reduce STIs and unintended pregnancy. According to the CDC (2010) condom distribution programs are a useful HIV reduction intervention strategy because they address "external factors that impact personal risk for HIV." Recent epidemiological investigations indicated condom distribution programs are effective in increasing condom use and decreasing STI incidence among preferred populations (Charania et al., 2011).

Despite the role of condoms in reducing STIs and unintended pregnancy, few studies have assessed condom distribution programs and sexual health interventions among colleges and universities. A recent study by Butler and colleagues (2011a) evaluated condom and safer sex product availability among 358 student health service departments nationwide. Results indicated that 84.9% of all schools distribute condoms to their students. The M number of condoms distributed/year was 9,414 (Mdn = 3,000 and Mo = 0). The most common method of distribution was educational outreach on campus (67.0%), followed by events on campus (61.7%), and the least common method was outreach conducted at local bars and restaurants (7.5%). Less than half of participating schools offered products other than male latex condoms such as sexual lubricants, latex dams, female condoms, and condoms above/below typical size. School demographics were found to correlate to condom availability with public schools more likely to sponsor a condom distribution program and significantly distribute more condoms/year than private schools. Similarly, faith-based schools were less likely to offer condoms to students and the overall number of condoms given to students/year was significantly lower.

The recent investigation by Butler and colleagues (2011a) was the first empirical study to assess the mean number of condoms distributed to students/year nationally. The finding provides unique insight into the prevalence of condom distribution programs within schools as well as their utilization by student populations. Additional large-scale investigations with similar recruitment and sampling methodologies are needed to corroborate this finding and increase the reliability of the results. More extensive evaluations of condom and safer sex product availability are needed including assessments of the relationship between various products and college/university demographics. In addition, while the study by Butler and colleagues (2011a) evaluated distribution methods sponsored by college health centers, future research is needed to assesses methods used to distribute condoms campus wide. Finally, in addition to information related to product distribution, more comprehensive assessments are needed to assess institutional policies and procedures related to condom distribution programs including strategies for advertising availability on campus.

The purpose of the present study was to assess the prevalence of condom and safer sex product distribution programs, condom distribution procedures, typical number of condoms given to students/year, demographic correlates of condom availability, and condom publicizing methods among U.S. colleges and universities.



Four hundred thirty-eight participants (39.8% response rate) who served as their campus ACHA representative or the director of student health services department completed questionnaires regarding their institution's condom and safer sex product-related services. Institutionally, the participants resided in 47 U.S. states and Washington D.C. The sum student population of participating institutions was 4.8 million. The M student population was 11,126 (SD = 12,680, Mdn = 6,000, and Mo = 12,000). Additional regional, institutional, and student population demographics are contained in Table 1.


Data were collected as part of a large national assessment of condom and safer sex product availability among U.S. colleges and universities [see Butler, Procopio, Ragan, Funke, and Black (2011) for an additional report on schools in rural areas]. All recruitment procedures were approved by the campus Institutional Review Board at Georgia College. A previous statistical power assessment by Butler and colleagues (2011a) conducted on colleges and universities nationally indicated a sample size of [greater than or equal to] 358 would be necessary for the present investigation. To meet this minimum requirement a sampling frame of 1,101 colleges and universities was identified. To be consistent with the previous investigation conducted by Butler and colleagues (2011a), a list of 759 institutional members of the American College Health Association (ACHA) was procured. This list was...

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