title: Geographic Variation in Condom Availability and Accessibility.
abstract: Identifying predictors that contribute to geographic disparities in sexually transmitted infections (STIs) is necessary in order to reduce disparities. This study assesses the spatial relationship condom availability and accessibility in order to better identify determinants of geographic disparities in STIs. We conducted a telephone-based audit among potential-condom selling establishments. Descriptive analyses were conducted to detect differences in condom-selling characteristics by stores and by store type. Geocoding, mapping, and spatial analysis were conducted to measure the availability of condoms. A total of 850 potential condom-selling establishments participated in the condom availability and accessibility audit in St. Louis city; 29 % sold condoms. There were several significant geographic clusters of stores identified across the study area. The first consisted of fewer convenience stores and gas stations that sold condoms in the northern section of the city, whereas condoms were less likely to be sold in non-convenience store settings in the southwestern and central parts of the city. Additionally, locations that distributed free condoms clustered significantly in city center. However, there was a dearth of businesses that were neither convenience stores nor gas stations in the northern region of the city, which also had the highest concentration of condoms sold. This initial study was conducted to provide evidence that condom availability and accessibility differ by geographic region, and likely are a determinant of social norms surrounding condom use and ultimately impact STI rates.
authors.affiliation: Department of Behavioral Science and Health Education, College for Public Health and Social Justice, Saint Louis University, 3545 Lafayette Avenue, Office 315, St. Louis, MO, 63104, USA. eshacham@slu.edu.
authors.forename: Enbal
authors.initials: E
authors.lastname: Shacham
authors.affiliation: Department of Epidemiology, College for Public Health and Social Justice, Saint Louis University, St. Louis, MO, 63104, USA.
authors.forename: Erik
authors.initials: E
authors.lastname: J Nelson
authors.affiliation: Department of Behavioral Science and Health Education, College for Public Health and Social Justice, Saint Louis University, 3545 Lafayette Avenue, Office 315, St. Louis, MO, 63104, USA.
authors.forename: Lauren
authors.initials: L
authors.lastname: Schulte
authors.affiliation: Department of Behavioral Science and Health Education, College for Public Health and Social Justice, Saint Louis University, 3545 Lafayette Avenue, Office 315, St. Louis, MO, 63104, USA.
authors.forename: Mark
authors.initials: M
authors.lastname: Bloomfield
authors.affiliation: Department of Behavioral Science and Health Education, College for Public Health and Social Justice, Saint Louis University, 3545 Lafayette Avenue, Office 315, St. Louis, MO, 63104, USA.
authors.forename: Ryan
authors.initials: R
authors.lastname: Murphy
mesh_terms: D016000:Cluster Analysis; D017280:Condoms / Q000600:supply & distribution*; D005260:Female; D040362:Geographic Information Systems; D015658:HIV Infections / Q000453:epidemiology* / Q000517:prevention & control* / Q000635:transmission; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D054625:Healthcare Disparities; D006801:Humans; D008297:Male; D012749:Sexually Transmitted Diseases / Q000453:epidemiology* / Q000517:prevention & control* / Q000635:transmission; D062206:Spatial Analysis
keywords: Condoms; Geographic information systems; Health status disparities; Sexually transmitted disease; Sexually transmitted diseases