Effects of condom social marketing on condom use in developing countries: a systematic review and metaanalysis, 1990-2010

The Medical University of South Carolina, Department of Psychiatry and Behavioral Sciences, Charleston, South Carolina 29425, USA.
Bulletin of the World Health Organisation (Impact Factor: 5.09). 08/2012; 90(8):613-622A. DOI: 10.2471/BLT.11.094268
Source: PubMed


To examine the relationship between condom social marketing programmes and condom use.
Standard systematic review and meta-analysis methods were followed. The review included studies of interventions in which condoms were sold, in which a local brand name(s) was developed for condoms, and in which condoms were marketed through a promotional campaign to increase sales. A definition of intervention was developed and standard inclusion criteria were followed in selecting studies. Data were extracted from each eligible study, and a meta-analysis of the results was carried out.
Six studies with a combined sample size of 23,048 met the inclusion criteria. One was conducted in India and five in sub-Saharan Africa. All studies were cross-sectional or serial cross-sectional. Three studies had a comparison group, although all lacked equivalence in sociodemographic characteristics across study arms. All studies randomly selected participants for assessments, although none randomly assigned participants to intervention arms. The random-effects pooled odds ratio for condom use was 2.01 (95% confidence interval, CI: 1.42-2.84) for the most recent sexual encounter and 2.10 (95% CI: 1.51-2.91) for a composite of all condom use outcomes. Tests for heterogeneity yielded significant results for both meta-analyses.
The evidence base for the effect of condom social marketing on condom use is small because few rigorous studies have been conducted. Meta-analyses showed a positive and statistically significant effect on increasing condom use, and all individual studies showed positive trends. The cumulative effect of condom social marketing over multiple years could be substantial. We strongly encourage more evaluations of these programmes with study designs of high rigour.

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    • "This review is part of a series of systematic reviews of HIV behavioral interventions in low- and middle-income countries conducted for the Evidence Project, a collaboration between the World Health Organization, the Medical University of South Carolina, and the Johns Hopkins Bloomberg School of Public Health. Other interventions that have been systematically reviewed through the Evidence Project include voluntary counseling and testing (VCT) [15], mass media [16], psychosocial support [17], treatment as prevention [18], peer education [19], positive prevention [20], condom social marketing [21] and provider-initiated testing and counseling [22]. For this project, we follow established PRISMA reporting guidelines [23] and use standardized methods across reviews. "
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