title: An intervention study examining the effects of condom wrapper graphics and scent on condom use in the Botswana Defence Force.
abstract: Free condoms provided by the government are often not used by Botswana Defence Force (BDF) personnel due to a perceived unpleasant scent and unattractive wrapper. Formative work with the BDF found that scented condoms and military-inspired (camouflage) wrapper graphics were appealing to personnel. A non-randomized intervention study was implemented to determine whether condom wrapper graphics and scent improved condom use in the BDF. Four military sites were selected for participation. Two sites in the south received the intervention condom wrapped in a generic wrapper and two sites in the north received the intervention condom wrapped in a military-inspired wrapper; intervention condoms were either scented or unscented. Two hundred and eleven male soldiers who ever had sex, aged 18-30 years, and stationed at one of the selected sites consented to participate. Sexual activity and condom use were measured pre- and post-intervention using sexual behavior diaries. A condom use rate (CUR; frequency of protected sex divided by the total frequency of sex) was computed for each participant. Mean CURs significantly increased over time (85.7% baseline vs. 94.5% post-intervention). Adjusted odds of condom use over time were higher among participants who received the intervention condom packaged in the military wrapper compared with the generic wrapper. Adjusted odds of condom use were also higher for participants who reported using scented vs. unscented condoms. Providing scented condoms and condoms packaged in a military-inspired wrapper may help increase condom use and reduce HIV infection among military personnel.
authors.affiliation: a Department of Defense HIV/AIDS Prevention Program , Naval Health Research Center , San Diego , CA , USA.
authors.forename: Bonnie Robin
authors.initials: BR
authors.lastname: Tran
authors.forename: Anne Goldzier
authors.initials: AG
authors.lastname: Thomas
authors.forename: Florin
authors.initials: F
authors.lastname: Vaida
authors.forename: Mooketsi
authors.initials: M
authors.lastname: Ditsela
authors.forename: Robert
authors.initials: R
authors.lastname: Phetogo
authors.forename: David
authors.initials: D
authors.lastname: Kelapile
authors.forename: Richard
authors.initials: R
authors.lastname: Haubrich
authors.forename: Christina
authors.initials: C
authors.lastname: Chambers
authors.forename: Richard
authors.initials: R
authors.lastname: Shaffer
mesh_terms: D000293:Adolescent; D000328:Adult; D001902:Botswana; D017280:Condoms / Q000706:statistics & numerical data*; D003268:Contraception Behavior / Q000706:statistics & numerical data*; D015658:HIV Infections / Q000517:prevention & control; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008889:Military Personnel / Q000706:statistics & numerical data*; D009812:Odorants; D011356:Product Labeling / Q000379:methods* / Q000706:statistics & numerical data*; D021841:Safe Sex / Q000706:statistics & numerical data; D040241:Social Marketing; D055815:Young Adult
keywords: HIV; HIV prevention intervention; condom use; military; sexual behaviors