Civil-Military Alliance
Goal
Prevent human immunodeficiency virus (HIV) infection and its related illness and death.
Overview
The HIV epidemic in the United States continues to be a major public health crisis. An estimated 1.1 million Americans are living with HIV, and 1 out of 5 people with HIV do not know they have it.1 HIV continues to spread, leading to about 56,000 new HIV infections each year.2
In 2010, the White House released a National HIV/AIDS Strategy. The strategy includes 3 primary goals:
Reducing the number of people who become infected with HIV.
Increasing access to care and improving health outcomes for people living with HIV.
Reducing HIV-related health disparities.
Why Is HIV Important?
HIV is a preventable disease. Effective HIV prevention interventions have been proven to reduce HIV transmission. People who get tested for HIV and learn that they are infected can make significant behavior changes to improve their health and reduce the risk of transmitting HIV to their sex or drug-using partners. More than 50 percent of new HIV infections3 occur as a result of the 21 percent of people who have HIV but do not know it.
Understanding HIV
In the era of increasingly effective treatments for HIV, people with HIV are living longer, healthier, and more productive lives. Deaths from HIV infection have greatly declined in the United States since the 1990s. As the number of people living with HIV grows, it will be more important than ever to increase national HIV prevention and health care programs.
There are gender, race, and ethnicity disparities in new HIV infections.2Condom Distribution as a Structural
Level Intervention
October 2010
Scientific Support for Programmatic Considerations for
Condom Distribution Condom Distribution
Individual-level and group-level risk reduction Programs should consider implementing CD
interventions are effective in increasing condom programs in their communities. As resources
use and reducing unprotected sex. These and capacity warrant, programs should also
types of interventions, however, focus on an consider integrating a CD program with
individual’s personal risk and do not address other HIV prevention strategies and health
barriers beyond the individual, such as not care services as part of a comprehensive HIV
having access to condoms. Structural-level prevention approach.
interventions are particularly attractive in HIV
prevention efforts because they are designed to Those interested in designing and implementing
address external factors that impact personal a CD program should consider including
risk for HIV. A recent meta-analysis (www. these elements:
springerlink.com/content/b587252l54332991/ • Provide condoms free of charge. fulltext.pdf), reviewing the scientific literature
• Conduct wide-scale distribution. on structural-level interventions aiming to
increase the availability, accessibility, and • Implement a social marketing campaign to
acceptability of condoms, found that: promote condom use (by increasing awareness
of condom benefits and normalizing condom • Structural-level condom distribution
use within communities). interventions or programs (CD programs)
are efficacious in increasing condom use, • Conduct both promotion and distribution
increasing condom acquisition or condom activities at the individual, organizational,
carrying, promoting delayed sexual initiation and environmental levels.
or abstinence among youth, and reducing • Target: 1) individuals at high risk, 2) incident STIs. venues frequented by high-risk individuals,
• Interventions that combined CD programs 3) communities at greatest risk for HIV
with additional individual-, group- or infection, especially those marginalized
community-level activities showed the by social, economic, or other structural
greatest efficacy. One possible reason for conditions, or 4) the general population
this is that these different modalities address within jurisdictions with high HIV incidence.
different behavioral determinants as well • Supplement the CD program with more as other prevention needs of individuals in intense risk reduction interventions or other
affected communities. prevention or health services for individuals
• CD programs were efficacious in increasing at highest risk. Integrate CD program
condom use among a wide range of activities within other community-level
populations, including youth, commercial sex intervention approaches to promote condom
workers, adult males, STD clinic patients, and use and other risk reduction behaviors.
populations in high risk areas. • Establish organizational support for condom
distribution and promotion activities in CD programs have been shown to be cost- traditional and non-traditional venues.
effective and cost saving. It was estimated • Conduct community-wide mobilization that one state-wide CD program led to saving
millions of dollars in future medical care costs efforts to support and encourage condom use.
by preventing HIV infections.