Despite the experience of the

Despite the experience of the past two decades, many questions remain unanswered
regarding the promotion, use and effectiveness of condoms. Objective and unbiased
research is needed and should, ideally, make it easier for condom programmes to ensure
an appropriate mix of prevention approaches that include condom promotion for key
populations at higher risk, promoting consistent condom use in stable relations, and
securing a regular supply of condoms to all who need them.
1. Build on the condom’s advantage. Condom promotion is an essential part of HIV
prevention programmes, both for key populations with high risk of HIV exposure and
for the general population. The use of condoms by those living with HIV enables them
to continue having a healthy and safer sex life. For sex workers in every country in the
world, condoms represent the only real option for reducing the risk of contracting and
transmitting HIV. Other groups whose risk of exposure is high include injecting drug
users and their sexual partners, and heterosexuals with many sexual partners or with a
high turnover of partners. Targeted condom promotion addresses the need for condom
availability at critical delivery points.
2. Condom promotion for the general population can encourage people to think and
talk about HIV prevention; it also helps to make safer sex the norm. Condom promotion
programmes have had the greatest impact on prevalence rates when introduced early in
a country’s epidemic and when they are accessed and used consistently by populations
at higher risk of HIV exposure. Condom promotion also yields other benefits, such as
preventing unintended pregnancy and reducing the transmission of other STIs.
Operational research is needed to determine both how condom promotion can best
be integrated into combination approaches to reduce sexual transmission of HIV and
to better understand the interactions that take place between different programme
components. It is essential that condom promotion programmes, while using successful
condom social marketing techniques to reduce common fears and misperceptions in the
general population, also target priority populations. In addition, such programmes must
incorporate approaches that create a more supportive sociocultural climate by providing
balanced arguments on the benefits of condom use versus its risks.