Condoms in a Hot Spot: Unlocking Access Joan M. Chow, MPH, DrPH - - PowerPoint PPT Presentation

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Condoms in a Hot Spot: Unlocking Access Joan M. Chow, MPH, DrPH STD Control Branch California Department of Public Health NCSD Engage 2017: Unwrapping Successful STD Program Condom Partnerships What are we covering today? Measuring condom

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Condoms in a Hot Spot: Unlocking Access

Joan M. Chow, MPH, DrPH STD Control Branch California Department of Public Health

NCSD Engage 2017: Unwrapping Successful STD Program Condom Partnerships

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Measuring condom access in partnership with the

2016 Healthy Stores Survey conducted by the Tobacco Control Program

Methods and Findings
Press coverage
Lessons for partnering with other programs

What are we covering today?

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Healthy Stores is a California statewide survey of tobacco retailers also covering food, alcohol, and condom availability.

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Why partner with Healthy Stores?

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100 200 300 400 500 1990 1995 2000 2005 2010 2016 Rate per 100,000 population Year Chlamydia 504.4 (N=198,503) Gonorrhea 164.3 (N=64,677) Early Syphilis 28.5 (N=11,222)

California STD rates are high, and getting higher!

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Condoms are an important STD prevention tool, but many challenges exist for youth to obtain condoms.

Of 177 young people who ordered condoms to be delivered at home through the CA Condom Access Project, the two main reported barriers to buying condoms were embarrassment and cost.

5% 13% 38% 53% 54% Other Didn't know where to buy Transportation Cost Embarrassment

Data Source: Home Mailer Youth Surveys, October 2013-February 2015

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Require less travel
More densely located
More sustainable

Retail store condom access has many advantages over public health free condom distribution

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STDs are not evenly distributed...

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…Neither are condoms

Previous research shows that:

Condoms are oddslot less likely to be

available in disadvantaged areas.

Limited availability of condoms was found to be

significantly associated with higher STD rates.

Rizkalla, 2010; Shacham, 2015

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Healthy Stores Survey Methods

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Random sample of zip codes with all eligible stores

surveyed within each zip

Stores had to be licensed to sell tobacco and not

restrict youth surveyors from entering

Over 7,100 total stores surveyed statewide

Sampling

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Behind counter, visible Behind counter, not visible On shelf, locked up On shelf, unlocked

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Healthy Stores Survey Findings

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81%

f surveyed stores sold condoms.

Only 5 counties reported that fewer than 70% of stores sold condoms. Availability of condoms in counties ranged from 49-92%.

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But in only

37%

can you purchase condoms without asking for a clerk’s help.

Nearly twice as many stores sell alcohol as sell unlocked condoms. Availability of unlocked condoms in counties ranged from 10-82%.

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For public health programs: $0.30 Corner stores: $3.43 Drugstores/pharmacies: $5.60 For all stores: $3.82 Average price of 3 condoms

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Is there a relationship between distribution of stores selling unlocked condoms and GC rates?

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GC “hotspots” were defined as zip codes in the top

15th percentile of rates.

Exclusions
GC cases that did not have a geocodable zip code in-

state

Zip codes that had less than 21 GC cases
Zip codes that had less than 7 stores surveyed
182 total zip codes were included (36 hotspots and

146 non-hotspots), covering 4,910 stores.

Geographic analysis

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Rate: 246.8 % unlocked: 40% Rate: 2,514.1 % unlocked: 38.5% Rate: 566.8 % unlocked: 26.5% Rate: 499.5 % unlocked: 0%

San Francisco

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Rate: 207.2 % unlocked: 36.5% Rate: 745.7 % unlocked: 26.1% Rate: 361.6 % unlocked: 9.4%

Bakersfield, KERN County

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California

27% 47%

In hotspots, an average of 27% of stores sold unlocked condoms. In non-hotspots, an average of 47%

f stores sold unlocked condoms.

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Press Coverage

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http://www.vcstar.com/story/news/local/2017/03/08/stores-flood-kids-poor- choices-officials-say/98867590

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https://www.edhat.com/site/tidbit.cfm?nid=182697

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Lessons from partnering with

ther public health programs

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Increased awareness of STDs, importance of condoms

among colleagues in alcohol, tobacco, and nutrition

Generated lots of press about condoms and STDs

Side Benefits

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Educate retailers in GC hotspots to improve

accessibility

Consider financial incentives for “healthy stores”who

integrate condom access

Improve targeting free condom distribution

What’s next?

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Henriksen L, et al. Tob Control 2016;25:i67–i74. doi:10.1136/tobaccocontrol-2016-053076

Collaborate with existing surveys to measure retail condom access

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Fewer silos mean better work!

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California Tobacco Control Program; Nutrition Education &

Obesity Prevention Program; Substance Use Disorders Program

Dan Wohlfeiler, MJ MPH, Chief, Office of Public/Private

Partnerships, CDPH STD Control Branch

Emily Han, MPH, Epidemiologist, CDPH STD Control Branch
Photo credits to Healthy Stores for Healthy Community Survey
Icon credits to respective authors on The Noun Project

(thenounproject.com)

Acknowledgements

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