title: Geospatial analysis of condom availability and accessibility in urban Malawi.
abstract: Prevalence of HIV in sub-Saharan African countries persists at alarming rates. There are currently four promoted methods to prevent HIV infection: adherence to antiretroviral therapy, male circumcision, pre-exposure prophylaxis and use of condoms. This study aimed to assess the availability and accessibility of one of the prevention efforts, condoms, in Kawale, Lilongwe, Malawi. A total of 220 potential condom-selling establishments were surveyed in 2012. Data were collected with store owners or staff and locations were geocoded to assess store density. Descriptive analyses were conducted. Of those audited, 96 stores sold condoms, 13 of which distributed free condoms. The stores were most often small shops and located in markets or trading centres. Condoms were most often found at the back of the store in an open space. There were approximately 1.2 stores per ¼ mile; 44% of the businesses in the study region carried condoms. This one method of prevention exhibited multiple barriers in this region: few stores sold condoms, high costs, condom locations within stores and limited availability. The limited accessibility is likely to influence social norms surrounding condom use. Future research should incorporate assessing norms and addressing barriers to uptake of HIV prevention efforts.
authors: College for Public Health and Social Justice, Saint Louis University, St. Louis, MO, USA eshacham@slu.edu.
authors: Enbal
authors: E
authors: Shacham
authors: Department of Economics, University of Michigan, Ann Arbor, MI, USA.
authors: Rebecca
authors: R
authors: Thornton
authors: Department of Economics, Williams College, Williamstown, MA, USA and International Food Policy Research Institute, Markets, Trade and Institution, Washington, DC, USA.
authors: Susan
authors: S
authors: Godlonton
authors: College for Public Health and Social Justice, Saint Louis University, St. Louis, MO, USA.
authors: Ryan
authors: R
authors: Murphy
authors: College for Public Health and Social Justice, Saint Louis University, St. Louis, MO, USA.
authors: Jake
authors: J
authors: Gilliland
mesh_terms: D000163:Acquired Immunodeficiency Syndrome; D017280:Condoms / Q000706:statistics & numerical data / Q000600:supply & distribution*; D005240:Feasibility Studies; D015658:HIV Infections / Q000453:epidemiology / Q000517:prevention & control*; D007722:Health Knowledge, Attitudes, Practice; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D006801:Humans; D008295:Malawi / Q000453:epidemiology; D008297:Male; D015995:Prevalence; D012111:Residence Characteristics; D012749:Sexually Transmitted Diseases / Q000453:epidemiology / Q000517:prevention & control*
keywords: Africa; Condom; HIV/AIDS; STD/STI prevention; accessibility and availability; geographic disparities; geospatial analysis; sexually transmitted infections