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Member Research & Reports

Member Research & Reports

Saint Louis Tests ‘Condom Audit’ Concept, Finds Scarcity in Malawi

People cannot use condoms – one of four promoted methods to prevent HIV infection – if they cannot buy them.

Enbal Shacham
[Photo: Dr. Enbal Shacham. Photo credit: Ms. Kim Donoghue, CPHSJ Communications]

A recent study out of Saint Louis University’s College for Public Health and Social Justice combined a field survey with geospatial analysis to determine whether residents of a small urban area in Malawi could easily purchase prophylaxes.

Through a “condom audit” of 220 potential vendors and analysis of their spatial distribution, researchers found condoms were expensive and not widely available.

Geographically, the study found that there were approximately 1.2 stores per .25 mile that carried condoms, and only 13 stores provided free condoms; and most condoms were stored at the back of the store.

In sub-Saharan Africa, where prevalence of HIV persists at “alarming rates,” identifying barriers to condom use provides important insight on how to improve services or tailor interventions.

“When condoms aren’t available, HIV prevention is not realistic in this social and physical context,” says Dr. Enbal Shacham, associate professor of behavioral science and health education at Saint Louis University’s College for Public Health and Social Justice.

Indeed, the scarcity of condoms may have further repercussions. “Community members are likely to assume that since they do not see them widely available, no one uses them,” the paper asserts.

The goal of the study, conducted in February 2012, was to test the feasibility of a “condom audit” so future research could examine other geographic resources and spatial patterns. Dr. Shacham has since studied “condom deserts” and rates of sexually transmitted infections in St. Louis, Missouri.

The paper, “Geospatial analysis of condom availability and accessibility in urban Malawi,” was co-authored by Dr. Rebecca Thornton, department of economics, University of Illinois; Dr. Susan Godlonton, department of economics, Williams College; Mr. Ryan Murphy and Mr. Jake Gilliland of Saint Louis University’s College for Public Health and Social Justice.

It appeared in the January issue of the International Journal of STD & AIDS.