Condom Distribution Structural Intervention (CDSI)
Condom Distribution Structural Intervention (CDSI) is a part of the HIV and sexually transmitted infection (STI) prevention strategy that helps increase the availability, accessibility, and acceptability of condoms in an effort to prevent HIV and STI transmission.
About Condom Distribution Structural Interventions
Condom distribution is a cost-effective structural intervention that provides communities with resources needed to prevent HIV and STI transmission. Making condoms widely available through condom distribution programs (CDPs) is integral to successful HIV prevention. CDC requires select funding recipients to implement CDPs as part of a larger HIV prevention strategy.
- Identify the internal and external factors that will help build effective CDPs at:
- Venues frequented by people with HIV and sexually transmitted infections (STI) risk factors.
- Communities disproportionately affected by HIV, especially those marginalized by social, economic, or other structural conditions.
- The general population within jurisdictions with high HIV incidence.
- Develop a process for identifying and engaging appropriate community partners and agencies that plan, implement, manage, or provide resources to support CDPs.
- Identify difficulties, such as reaching members of populations with HIV and STI risk factors or groups that have been marginalized, and strategies to overcome those challenges.
- Conduct an evaluation to identify any structural barriers and ensure that condoms are available in the locations where members of the population at increased risk for HIV are found (e.g., pharmacies, condom dispensing machines, outreach workers).
- Ensure CDP is accessible in venues frequented by disproportionately affected populations (e.g., massive distribution of free condoms).
- Ensure that CDP is acceptable to community members and in alignment with social norms (e.g., social marketing of condoms).
- Calculate the costs and determine the scale of the CDP.
- Identify the laws, policies, or practices that may support or hinder a CDP.
- Define programmatic objectives, key indicators (e.g., number of condoms distributed) for measuring the program’s performance, and how data will be collected.
- Identify number of agencies, venues, or settings where free condoms are distributed.
- Identify estimated number of audience impressions from campaign messages.
To design and implement an effective structural-level CDP, organizations are encouraged to adhere to the following elements:
- Provide condoms free of charge.
- Conduct wide-scale distribution.
- Implement a social marketing campaign to promote condom use.
- Conduct promotion and distribution activities at the individual, organizational, and environmental levels.
- Complement the CDP with more intense risk-reduction interventions and services.
- Integrate distribution program activities within other community-level interventions.
- Establish organizational support for condom distribution and promotion activities.
- Conduct community-wide mobilization efforts.
Population of Focus
Communities overrepresented in the HIV epidemic.
There is no CDC-supported training currently available for CDSI. Technical assistance (TA) for the implementation of CDP, including jurisdictional Condom Distribution as a Structural Intervention (CSDI) institutes, is available.
To request technical assistance:
- CDC’s directly funded health department and CBO partners may request technical assistance by submitting a request in the CBA Tracking System.
- Organizations not directly funded by CDC may contact their local health department for assistance in submitting a request.
If you have questions or need additional assistance, please contact HIVCBA@cdc.gov.
CDC provides funding for condom distribution programs through health departments but does not provide condoms for distribution directly. Please contact your state or local health department for assistance obtaining condoms for distribution.
Below are examples of a few health department CDPs. Other CDPs may be available in your area.
- Health Department CDPs
NYC Condom: Managed by the New York City Department of Health, NYC Condom provides free male and female condoms, personal lubricant, dental dams, and finger cots to eligible organizations. Its website provides information about the program, an eligibility determination form, an online request form, CDP FAQs, product descriptions, and links to general information about male and female condoms, HIV, AIDS, and STIs. Other services include:
- A list of organizations (searchable by borough and zip code) that provide free male condoms, female condoms, and lubricant;
- Contact information, including email addresses and a 311-telephone line;
- Resources for confidential testing, female condoms, emergency contraception, HIV and STI testing centers, and other public health organizations focusing on sexual and reproductive health;
- An online order form where eligible organizations can request free condoms and lubricant; and
- Social marketing tools of their NYC Condom media campaigns, including TV spots, subway ads, posters, and web banner ads available in both English and Spanish.
DC Health and Wellness Center: Managed by the District of Columbia (DC) Department of Health’s HIV/AIDS, Hepatitis, STD, and TB Administration, the DC Health and Wellness Center provides free condoms and lubricant packages to individuals and organizations. Its Sex Positive website offers a variety of tools designed for the DC community to easily educate itself and obtain free safe sex resources, including:
- Types of condoms: Detailed description of the most common types, including latex and female condoms;
- Condoms 101: Contains information about the proper use of male condoms, female condoms, and dental dams;
- An online Condom Distribution Order Form-DC Residents where persons residing in DC can quickly order a package of free condoms; and
- An online Condom Distribution Order Form-Partners where community partners can order condoms and lubricant packages to provide at their locations for free.
Philadelphia Department of Public Health (PDPH): To ensure that free condoms are available for anyone who requests them, PDPH provides condoms for distribution to more than 100 unique sites across the city. Agencies can become a condom distribution site by filling out a registration form. Like DC Health, PDPH also operates a social media website, Take Control Philly, where persons can find information about STDs, the importance of condom use, how to have condoms sent through the mail, and how to find more information. The site also features maps of free condom distribution sites. Check out these resources in action!
- Community-Based CDPs
- San Francisco AIDS Foundation: The San Francisco AIDS Foundation has given away millions of condoms and packets of lubrication to individuals, businesses, agencies, and organizations in the city and county of San Francisco. Its website provides extensive information about the Foundation, including HIV and STI testing resources, counseling and case management, syringe access and disposal, and an online list of locations providing free condoms and safer sex supplies.
- AIDS Healthcare Foundation’s (AHF’s) Love Condoms Campaign: According to its website, AHF’s Love Condoms Campaign is designed to “promote widespread access, usage, and acceptance of condoms as a vital component of Global AIDS Control.” To do so, AHF not only provides condoms to individuals and organizations, but it actively engages communities throughout the world via social media and advocacy. AHF hosts an annual International Condom Day with events hosted worldwide where advocates and staff with the campaign give away free condoms to the public. In 2018, AHF distributed more than 600 million condoms in more than 37 countries.
Outreach materials available to distribution partners include an online order form for individuals and organizations and educational resources pertaining to the proper use of condoms and the prevention of HIV. For more information, contact AHF at 6255 W. Sunset Boulevard, 21st Floor, Los Angeles, CA 90028, or (323) 860-5200.
- Risk Reduction Interventions with Condom Distribution Elements
CDC has several evidence-based interventions that are designed to increase the availability, accessibility, and acceptability of condoms:
- PROMISE for HIP focuses on a variety of populations; includes identification of community needs and potential priority populations, creation of role model stories from individuals who have made positive HIV/ STI behavior change, and distribution of these role model stories and condoms by peer advocates.
- d-up: Defend Yourself! is an intervention designed by and for Black gay, bisexual, and other men who have sex with men (MSM) that promotes social norms of condom use through endorsement by trained opinion leaders and assists in recognizing and addressing risk-related racial and sexual bias in order to increase self-worth.
- The Transgender Women Involved in Strategies for Transformation (TWIST) intervention integrates condom use through the following:
- Discussing condom use as a way to protect the individual, their sexual partners, and their future.
- Different types of condoms are described and explained related to their characteristics (latex or not; advantages of each, cost, etc.).
- Distributing handouts with listed steps and an acronym on how to use condoms (insertive/male and non-insertive/female) that accompanies a condom use activity.
- Participants receive descriptions of condoms and their use and the use models of male and female genitalia to practice using the condoms under the observation of the trainers.
- If time permits, there is a contest on being able to correctly use a condom.
- Questions are embedded in at least three activities that focus on condom negotiation skill building, facts related to condom use, and understanding the risk of exposure to HIV or STIs of different sex-related activities.
- Condoms and STDs: Fact Sheet for Public Health Personnel
- Condom Factsheet in Brief
- STD Treatment Guidelines: Clinical Prevention Guidance
- Condom Distribution as a Structural Level Intervention
- Efficacy of Structural-Level Condom Distribution Interventions: A Meta-Analysis of U.S. and International Studies, 1998-2007