Condom use during a community intervention trial in Kenya

Area of Science:

• Public Health
• Epidemiology
• Sexual Health

Background:

• Sexually transmitted infections (STIs) remain a significant global health challenge.
• Effective prevention strategies are crucial, particularly in resource-limited settings.
• Female condoms offer an alternative or adjunct to male condoms for STI and unintended pregnancy prevention.

Purpose of the Study:

• To evaluate the impact of introducing female condoms on STI prevalence in Kenyan agricultural communities.
• To assess male and female condom use patterns within intervention and control groups.
• To identify barriers to condom use in the study population.

Main Methods:

• A cluster-randomized community intervention trial was conducted at Kenyan agricultural sites.
• Intervention sites received risk-reduction campaigns and distribution of both female and male condoms.
• Control sites received risk-reduction campaigns and male condoms only.

Main Results:

• Self-reported male condom use increased to over 60% in both groups.
• Consistent male condom use was higher in control sites (23% at 6 months) compared to intervention sites (14% at 6 months).
• Consistent female condom use was low (11% at 6 months, 7% at 12 months) and decreased over time, with a growing proportion of non-users.

Conclusions:

• The female condom intervention did not reduce STI prevalence compared to male condom promotion alone.
• Barriers including male partner objections, community suspicion, and provider bias hindered condom use.
• A significant proportion of sexual acts remained unprotected, highlighting the need for improved strategies.