Barriers to Purchasing Condoms in a High HIV/STI-Risk Urban Area

The Centers for Disease Control and Prevention (CDC) have identified Atlanta, Georgia as a high-risk environment for STI/HIV infection. Condoms are an inexpensive and effective method for preventing STI/HIV infection. The majority of individuals acquire their condoms through purchase, rather than through free condom distribution programs. However, individuals purchasing condoms in stores encounter numerous barriers. This study assessed the environmental and physical barriers surrounding condom purchases in stores in downtown Atlanta. The findings revealed a combination of high environmental and physical barriers, low visibility of condoms in stores and limited selection of safer sex supplies. In the most densely populated area of the city, stores which sold condoms were few (n = 25), equating to 1 store per ~ 7000 people. In 80% of stores, personnel were required in order to access the condoms. In 28% of stores, condoms were hidden underneath the counter. The majority of stores offered only one brand of male condoms with a limited selection of lubricants and no dental dams or internal condoms. Barriers and discomfort surrounding purchasing condoms can contribute to embarrassment, which has a negative impact on condom acquisition and ultimately on condom use. Efforts must be made to lower barriers in Atlanta and make condoms more readily available to high-risk populations. Community advocacy has been effective in removing barriers to condoms. Access can furthermore be improved by: installing condom vending machines in public locations, offering self-check-out in stores that do not have physical barriers and encouraging individuals to order condoms online.