Explaining inconsistencies between data on condom use and condom sales

Area of Science:

• Public Health
• Epidemiology
• Reproductive Health

Background:

• HIV prevention programs often rely on condom sales and survey data for progress monitoring.
• Inconsistencies between condom sales and prevalence data hinder accurate program evaluation.
• There is a need to assess the utility of survey data for estimating condom usage and needs.

Purpose of the Study:

• To explain inconsistencies between condom sales and survey-based condom prevalence data.
• To assess the feasibility of estimating the number of sex acts and condoms used from survey data.
• To provide program managers with tools for estimating condom requirements for target populations.

Main Methods:

• Utilized data from six Demographic and Health Surveys (DHS).
• Estimated annual sex acts using coital frequency and intercourse reporting.
• Estimated annual condom usage based on self-reported frequency and condom use during intercourse.

Main Results:

• Condom sales data exhibit erratic patterns due to supply chain dynamics, making them poor indicators of actual use.
• Estimates of sex acts and condom usage derived from survey data vary significantly depending on the methodology.
• The highest estimate for annual condom usage was tenfold the lowest estimate in some surveys.

Conclusions:

• Condom sales data are insufficient for monitoring HIV prevention programs due to their unreliability.
• While survey data offer potential for detailed monitoring, converting prevalence data into usage estimates is complex and yields inconsistent results.
• Further research is needed to establish the reliability of different estimation methods before survey data can be confidently used to estimate annual condom usage.