Condom Social Marketing Effects in Low- and Middle-Income Countries: A Systematic Review Update, 1990 to 2019

Area of Science:

• Public Health
• Social Marketing
• HIV Prevention

Background:

• Prior systematic reviews have examined condom social marketing (CSM) programs.
• There is a need to update the evidence on CSM's impact on condom use in low- and middle-income countries (LMICs).

Purpose of the Study:

• To systematically review studies published in the last nine years evaluating the effects of CSM programs on condom use in LMICs.
• To assess the effectiveness of CSM in promoting safer sexual practices and preventing HIV transmission.

Main Methods:

• A systematic literature search was conducted across multiple databases (PubMed, CINAHL, PsycINFO, Sociological Abstracts, EMBASE) and hand searching of key journals.
• Studies published between 1990 and January 16, 2019, in LMICs, evaluating CSM, and measuring condom use behavior were included.
• Data extraction followed PRISMA guidelines, with two independent reviewers assessing study characteristics and outcomes.

Main Results:

• The previous review (2012) included 6 studies (N=23,048) and found a pooled odds ratio for condom use of 2.01 (95% CI: 1.42-2.84) for the most recent sexual encounter.
• A meta-analysis indicated a pooled odds ratio of 2.10 (95% CI: 1.51-2.91) for composite condom use outcomes.
• Despite the positive findings, studies had significant methodological limitations.

Conclusions:

• No new studies meeting the inclusion criteria were identified for the update, indicating a dearth of recent research on CSM effectiveness in LMICs.
• More methodologically rigorous studies are required to provide robust evidence for the global implementation of CSM programs.
• The findings suggest a need for continued research to strengthen the evidence base for CSM in HIV prevention efforts.