Female condom introduction and sexually transmitted infection prevalence: results of a community intervention trial in Kenya.
OBJECTIVE
To measure the impact on sexually transmitted infection (STI) prevalence of a female condom introduction and risk-reduction program at Kenyan agricultural sites.


METHODS
We conducted a cluster-randomized trial to determine whether a replicable, community-level intervention would reduce STI prevalence.


METHODS
Six matched pairs of tea, coffee and flower plantations were identified. The six intervention sites received an information/motivation program with free distribution of female and male condoms, and six control sites received only male condoms and related information. Participants were tested for cervical gonorrhea and chlamydia by ligase chain reaction on urine specimens, and vaginal trichomoniasis by culture, at baseline, 6 and 12 months.


RESULTS
Participants at intervention (n = 969) and control sites (n = 960) were similar; baseline STI prevalence was 23.9%. Consistent male condom use was more than 20% at 12 months. Consistent female condom use was reported by 11 and 7% of intervention site women at 6 and 12 months. Unadjusted STI prevalence was 16.5 and 17.4% at 6 months, and 18.3 and 18.5% at 12 months, at the intervention and control sites, respectively. Logistic regression models confirmed the null effect of the female condom intervention.


CONCLUSIONS
Female condom introduction did not enhance STI prevention at these sites. It is unclear which aspects of the intervention -- STI education, condom promotion, case management -- were associated with decreased STI prevalence from baseline to follow-up.
Feldblum
P J
PJ
Family Health International, Research Triangle Park, North Carolina 27709, USA. pfeldblum@fhi.org
Kuyoh
M A
MA
Bwayo
J J
JJ
Omari
M
M
Wong
E L
EL
Tweedy
K G
KG
Welsh
M J
MJ
D000328:Adult; D002690:Chlamydia Infections / Q000453:epidemiology / Q000517:prevention & control / Q000635:transmission; D017280:Condoms / Q000706:statistics & numerical data*; D019111:Single-Use Internal Condom / Q000706:statistics & numerical data*; D003625:Data Collection; D005260:Female; D005500:Follow-Up Studies; D006069:Gonorrhea / Q000453:epidemiology / Q000517:prevention & control / Q000635:transmission; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007630:Kenya / Q000453:epidemiology; D016015:Logistic Models; D008297:Male; D015995:Prevalence; D011897:Random Allocation; D012424:Rural Population; D021841:Safe Sex; D012736:Sex Education; D012749:Sexually Transmitted Diseases / Q000453:epidemiology / Q000517:prevention & control / Q000635:transmission*; D014247:Trichomonas Vaginitis / Q000453:epidemiology / Q000517:prevention & control / Q000635:transmission