RELEVANCE TO UNDER-RESOURCED SETTINGS

RELEVANCE TO UNDER-RESOURCED SETTINGS

Magnitude of the problem

This review is of high relevance to under-resourced settings. The very high rates of HIV infection, and sexually transmitted infections (STIs) that contribute to HIV transmission, have been well documented in much of sub-Saharan Africa (levels of HIV around 30% in some parts), Asia and the rest of the developing world. Another related problem is the low and inconsistent use of condoms in most of the affected areas.

Feasibility of the intervention

The widespread, correct and consistent use of male condoms is probably the most feasible HIV prevention strategy available. Compared with other health strategies that require doctors, nurses, health workers, clinics, fridges, needles and so on, condoms can be safely and effectively promoted, distributed and used. Yes, there are barriers—including cultural and social ones—but there can be no denying the ready availability of an intervention that provides substantial protection.

Applicability of the results of the Cochrane Review

The cost of condoms is low, and various social marketing projects and programmes have shown widespread distribution to be feasible. Without doubt different difficulties will be faced in different locations, but local expertise and interest will overcome these.

Implementation of the intervention

Condom distribution already occurs in many different ways through most of the developing world, using a wide range of networks ranging from formal health sectors, through social Research

Perhaps the key focus for future research needs to be on how best to increase distribution and uptake of condoms in as many different locations as possible, rather than on further refinement of knowledge of the actual effectiveness of condoms.