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close this bookEffective Approaches for the Prevention of HIV/Aids in Woman (PAHO, WHO; 1995; 62 pages)
View the documentExecutive summary
View the document1. Introduction
View the document2. Opening of the meeting
Open this folder and view contents3. Women and HIV/AIDS
close this folder4. Effective approaches to prevention of HIV/AIDS in women
Open this folder and view contents4.1 Promoting safer sexual behaviour
close this folder4.2 Prevention of HIV/AIDS/STD through STD care and condom promotion
View the documentCommunity peer education to prevent STD/HIV/AIDS among women in Zimbabwe and Zambia
View the documentA comprehensive STD/HIV intervention programme in India
View the documentWomen’s Protection Project: condom social marketing for women in Haiti
View the documentEffective approaches to HIV/AIDS prevention through STD care and condom promotion - Conclusions
Open this folder and view contents5. Experiences from other fields: implications for HIV/AIDS prevention
Open this folder and view contents6. Future directions: national policies and large-scale programmes
View the document7. Overall conclusions
View the documentAppendix 1 - Agenda
View the documentAppendix 2 - List of participants
View the documentAppendix 3 - List of background papers
View the documentAppendix 4 - Selected reading list

Women’s Protection Project: condom social marketing for women in Haiti

Presented by Dr Yolene Surena, Populations Services International, Port-au-Prince, Haiti

Haiti is one of the countries in the Americas to have been most affected by the AIDS epidemic - 8% of the general population is seropositive. HIV prevalence in certain populations, such as commercial sex workers and their clients, STD patients and tuberculosis patients, is very high (sometimes reaching 40%). The predominant mode of HIV transmission is heterosexual and the male-to-female ratio currently stands at one-to- one. Clearly, in this and similar scenarios, many sexually active women are at risk and yet women who are sexually active but who are not commercial sex workers, and women who have regular partners who are ‘high-frequency’ transmitters, rarely benefit from targeted condom promotion and education efforts.

Educating women on how to protect themselves from STD/HIV, making condoms available to women, and encouraging social support for condom use through media campaigns are the broad aims of a new initiative in Haiti - the Women’s Protection Project. Population Services International (PSI), a major supporter of this project, is an organization with worldwide experience in promoting condoms for family planning and AIDS prevention, and is known for its pioneering work and many achievements in condom social marketing. To date, however, the vast majority of such programmes have targeted only men.

This project, being launched in Brazil and Cameroon as well as Haiti, will try to reach women who are sexually active but not involved in commercial sex work and who are aware of the risks they run when they have sex with a husband or boyfriend who has sexual relationships with other partners, including sex workers, and/or who have multiple partners themselves. This target group will be segmented according to differences among the women. Communication strategies will be developed to meet the needs of women at different stages in the life cycle. Subgroups will include young unmarried women, young married women, older unmarried women and older married women. Attention will also be paid to differences in educational level, economic situation and occupation. Likewise, all messages will acknowledge various issues important to these women, such as the role of condoms in preventing unwanted pregnancies.

The specific objectives of this female-oriented condom social marketing scheme are to: market condoms specifically to women at an affordable price using product packaging that is discreet and appealing to women, product advertising that stresses women’s rights to control their own sexuality and protect their reproductive health, and product sales outlets that correspond to women’s needs for discretion and easy accessibility; conduct mass media public education campaigns that stress women’s right to have a say in sexual decision-making and to insist upon protection in all relations; and implement a wide range of interpersonal communications that address the issue of negotiating condom use in sexual relationships.

To be successful, a major condom social marketing campaign combined with mass media and IEC activities, requires a thorough understanding of the target audience before appropriate message design and content and marketing strategies can be developed. The team in Haiti has obtained some of the needed information. For example, data collected at 21 sales points for one week determined the percentage of condoms sold that were bought by women, their age groups, the time of day they purchased condoms most and the most used type of sales outlet. Women represented 12% of all customers purchasing condoms and the majority of them were young. Women preferred to buy from self-service markets, department stores, or bazaars (from female street vendors) and outside of peak shopping hours. This information was used to develop a pilot condom network of 70 sales outlets that were located in cities, towns, and semi-urban and rural districts, and that were accessible to women and met their needs for discretion. Retailers were visited daily for approximately 20-30 days to provide information on topics such as proper condom use, storage of condoms, and effective marketing of the products.

To determine the appeal of special packaging of condoms designed to be attractive to women, the sales of two models were monitored - “Femme” (woman) and “Fleur” (flower). Sales records for the last month of this project showed that these two brands accounted for 37% of the total market share of condom sales in the 70 outlets. It was also found that 85% of female customers bought condoms together with other products while 54% of male customers did so.

Also of interest were discussions on issues concerning the use of condoms within a stable partnership. In groups of women assembled to discuss condom use, women expressed a keen interest in obtaining information to pass on to others, but they generally felt that they themselves were not in a position to negotiate condom use despite the fact that the majority of them raised doubts as to their partner’s fidelity. Sixty percent of the women said that they would not attempt to place a condom on their partner during intercourse. Among the reasons given for this reluctance were that condom use was for “city” women, and lack of experience or the habit of touching their partner’s genitals. Addressing some of these concerns will be crucial in all aspects of this ‘condom promotion for women’ campaign.

Lessons learned

• Condom promotion and distribution for sexually active women who are not commercial sex workers has been virtually non-existent and efforts to fill this gap should be intensified. Condom promotion and social marketing programmes should be specifically designed and tailored to serve HIV-vulnerable women in the general population.

• Condoms should be promoted and distributed through as many channels as possible, in order to ensure their availability to as large a proportion of the total population, including women, as possible.

• Condom social marketing is likely to be more effective if accompanied by mass media and IEC activities that communicate appropriate messages on issues like equality in relationships and that help to overcome social taboos on male-female dialogue about sexuality and prevention. Audience participation in message design and development, careful training of distributors, and careful audience segmentation are essential.

• Operational research is a valuable tool for determining the most suitable types of outlets, and marketing and intervention strategies for different populations of women (e.g. young women), and for meeting their different needs.

• Often retailers do not actually promote condoms, or don’t display them clearly or in an appealing way. Many retailers feel reluctant or don’t know how to discuss condoms with their costumers. Information should be supplied to retailers on topics such as how to use condoms, STD/HIV prevention, how to store condoms, and basic marketing concepts.

• Condoms should not be promoted in ways that stigmatize women. Condoms should be promoted not simply as a way of preventing STD, but as part of a confident, desirable lifestyle.

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