Skip to main content

Advertisement

SpringerLink
Log in

Geographic Variation in Condom Availability and Accessibility

  • Original Paper
  • Published:
AIDS and Behavior Aims and scope Submit manuscript

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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Centers for Disease Control and Prevention. Sexually Transmitted Disease Surveillance, 2014. Atlanta: U.S. Department of Health and Human Services; 2015.

    Google Scholar 

  2. CDC. A glance at the HIV/AIDS epidemic Atlanta: Centers for Disease Control and Prevention; 2014. http://www.cdc.gov/hiv/topics/surveillance/resources/factsheets/incidence.htm. Cited 8 July 2014.

  3. Palella FJJ, Baker RK, Moorman AC, Chmiel JS, Wood KC, Brooks JT, et al. Mortality in the highly active antiretroviral therapy era: changing causes of death and disease in the HIV outpatient study. J Acquir Immune Defic Syndr. 2006;43(1):27–34.

    Article  CAS  PubMed  Google Scholar 

  4. Du P, McNutt L-A, O’Campo P, Coles FB. Changes in community socioeconomic status and racial distribution associated with gonorrhea rates: an analysis at the community level. Sex Transm Dis. 2009;36(7):430–8. doi:10.1097/OLQ.0b013e31819b8c2f.

    Article  PubMed  Google Scholar 

  5. Kaplan MS, Crespo CJ, Huguet N, Marks G. Ethnic/racial homogeneity and sexually transmitted disease: a study of 77 Chicago community areas. Sex Transm Dis. 2009;36(2):108–11. doi:10.1097/OLQ.0b013e31818b20fa.

    Article  PubMed  Google Scholar 

  6. Semaan S, Sternberg M, Zaidi A, Aral SO. Social capital and rates of gonorrhea and syphilis in the United States: spatial regression analyses of state-level associations. Soc Sci Med. 2007;64(11):2324–41.

    Article  PubMed  Google Scholar 

  7. Beer L, Oster AM, Mattson CL, Skarbinski J. Project ftMM. Disparities in HIV transmission risk among HIV-infected black and white men who have sex with men, United States, 2009. AIDS. 2014;28(1):105–14. doi:10.1097/QAD.0000000000000021.

    Article  PubMed  PubMed Central  Google Scholar 

  8. Feldacker C, Ennett ST, Speizer I. It’s not just who you are but where you live: an exploration of community influences on individual HIV status in rural Malawi. Soc Sci Med. 2011;72(5):717–25.

    Article  PubMed  Google Scholar 

  9. Gindi RM, Sifakis F, Sherman SG, Towe VL, Flynn C, Zenilman JM. The geography of heterosexual partnerships in Baltimore city adults. Sex Transm Dis. 2011;38(4):260–6.

    PubMed  Google Scholar 

  10. Reece M, Herbenick D, Schick V, Sanders SA, Dodge B, Fortenberry JD. Condom use rates in a national probability sample of males and females ages 14 to 94 in the United States. Malden: Blackwell Publishing Inc.; 2010. p. 266–76.

    Google Scholar 

  11. Cohen D, Scribner R, Bedimo R, Farley TA. Cost as a barrier to condom use: the evidence for condom subsidies in the United States. Am J Public Health. 1999;89(4):567–8.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  12. Dahl DW, Gorn GJ, Weinberg CB. The impact of embarrassment on condom purchase behaviour. Can J Public Health (Rev Can Sante’e Publique). 1998;89(6):368–70.

    CAS  Google Scholar 

  13. Compendium of evidence-based HIV behavioral intervention. CDC; 2014. http://www.cdc.gov/hiv/prevention/research/compendium/rr/complete.html. Cited 8 June 2014.

  14. Smith C, Butterfass J, Richards R. Environment influences food access and resulting shopping and dietary behaviors among homeless Minnesotans living in food deserts. Agric Hum Values. 2010;27(2):141–61.

    Article  Google Scholar 

  15. Ver Ploeg M, Breneman V, Farrigan T, Hamrick K, Hopkins D, Kaufman P, et al. Access to affordable and nutritious food—measuring and understanding food deserts and their consequences: report to congress. United States Department of Agriculture; 2009.

  16. USDA. Food Access Research Atlas 2015. http://www.ers.usda.gov/data-products/food-access-research-atlas.aspx. Cited 3 Apr 2015.

  17. Penchansky R, Thomas JW. The concept of access: definition and relationship to consumer satisfaction. Med Care. 1981;19(2):127–40.

    Article  CAS  PubMed  Google Scholar 

  18. Arcury TA, Preisser JS, Gesler WM, Powers JM. Access to transportation and health care utilization in a rural region. J Rural Health. 2005;21(1):31–8.

    Article  PubMed  Google Scholar 

  19. Reece M, Mark K, Schick V, Herbenick D, Dodge B. Patterns of condom acquisition by condom-using men in the United States. AIDS Patient Care STDS. 2010;24(7):429–33.

    Article  PubMed  Google Scholar 

  20. Institute of Medicine. State of the USA health indicators: letter report. Washington: The National Academies Press; 2009.

    Google Scholar 

  21. Bridle-Fitzpatrick S. Food deserts or food swamps: a mixed-methods study of local food environments in a Mexican city. Soc Sci Med. 2015;142:202–13.

    Article  PubMed  Google Scholar 

  22. Cannuscio C, Weiss E, Asch D. The Contribution of urban foodways to health disparities. Journal of Urban Health. 2010;87(3):381–93.

    Article  PubMed  PubMed Central  Google Scholar 

  23. Delamater PL, Messina JP, Shortridge AM, Grady SC. Measuring geographic access to health care: raster and network-based methods. Int J Health Geogr. 2012;11(1):1–18.

    Article  Google Scholar 

  24. Grubesic TH, Pridemore WA, Williams DA, Philip-Tabb L. Alcohol outlet density and violence: the role of risky retailers and alcohol-related expenditures. Alcohol Alcohol. 2013;48(5):613–9.

    Article  PubMed  Google Scholar 

  25. Schootman M, Deshpande AD, Lynskey MT, Pruitt SL, Lian M, Jeffe DB. Alcohol outlet availability and excessive alcohol consumption in breast cancer survivors. J Prim Care Community Health. 2013;4(1):50–8.

    Article  PubMed  Google Scholar 

  26. Glanz K, Rimer BK, Viswanath K. Health behavior and health education: theory, research, and practice. San Francisco: Wiley; 2008.

    Google Scholar 

  27. Mustanski B, Newcomb ME. Older sexual partners may contribute to racial disparities in HIV among young men who have sex with men. J Adolesc Health. 2013;52(6):666–7.

    Article  PubMed  PubMed Central  Google Scholar 

  28. Hudelson C, Cluver L. Factors associated with adherence to antiretroviral therapy among adolescents living with HIV/AIDS in low- and middle-income countries: a systematic review. AIDS Care. 2015;27(7):1–12.

    Article  Google Scholar 

  29. Wilson TE, Feldman J, Vega MY, Gandhi M, Richardson J, Cohen MH, et al. Acquisition of new sexual partners among women with HIV infection: patterns of disclosure and sexual behavior within new partnerships. AIDS Educ Prev. 2007;19(2):151–9.

    Article  PubMed  Google Scholar 

  30. Frye V, Koblin B, Chin J, Beard J, Blaney S, Halkitis P, et al. Neighborhood-level correlates of consistent condom use among men who have sex with men: a multi-level analysis. AIDS Behav. 2010;14(4):974–85.

    Article  PubMed  Google Scholar 

  31. Fichtenberg C, Jennings J, Glass T, Ellen J. Neighborhood socioeconomic environment and sexual network position. J Urban Health. 2010;87(2):225–35.

    Article  PubMed  PubMed Central  Google Scholar 

  32. Cubbin C, Santelli J, Brindis CD, Braveman P. Neighborhood context and sexual behaviors among adolescents: findings from the national longitudinal study of adolescent health. Perspect Sex Reprod Health. 2005;37(3):125–34.

    Article  PubMed  Google Scholar 

  33. Rizkalla C, Bauman LJ, Avner JR. Structural impediments to condom access in a high HIV/STI-risk area. J Environ Public Health. 2010;2010:1–5.

    Article  Google Scholar 

  34. ESRI. ArcGIS Desktop: Release 10. Redlands, CA: Environmental Systems Research Institute; 2011.

  35. Schonlau M, Scribner R, Farley TA, Theall K, Bluthenthal RN, Scott M, et al. Alcohol outlet density and alcohol consumption in Los Angeles county and southern Louisiana. Geospatial Health. 2008;3(1):91–101.

    Article  PubMed  PubMed Central  Google Scholar 

  36. Truong KD, Sturm R. Alcohol outlets and problem drinking among adults in California. J Stud Alcohol Drugs. 2007;68(6):923–33.

    Article  PubMed  Google Scholar 

  37. Kulldorff M. A spatial scan statistic. Commun Stat Theory Methods. 1997;269(6):1481–96.

    Article  Google Scholar 

  38. Kulldorff M. A spatial scan statistic. Commun in Stat Theory Methods. 1997;26(6):1481–96.

    Article  Google Scholar 

  39. Rothman KJ, Greenland S, Lash TL. Modern epidemiology. Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins; 2008.

    Google Scholar 

  40. Lawson AB, Biggeri AB, Boehning D, Lesaffre E, Viel JF, Clark A, et al. Disease mapping models: an empirical evaluation. Disease Mapping Collaborative Group. Stat Med. 2000;19(17–18):2217–41.

    CAS  PubMed  Google Scholar 

  41. R Core Team. R: A language and environment for statistical computing. R Foundation for Statistical Computing, Vienna, Austria. ISBN 3-900051-07-0. http://www.R-project.org/ (2012).

  42. Elliott P, Wartenberg D. Spatial epidemiology: current approaches and future challenges. Environ Health Perspect. 2004;112(9):998–1006.

    Article  PubMed  PubMed Central  Google Scholar 

  43. Clayton D, Kaldor J. Empirical Bayes estimates of age-standardized relative risks for use in disease mapping. Biometrics. 1987;43(3):671–81.

    Article  CAS  PubMed  Google Scholar 

  44. Charania M, Crepaz N, Guenther-Gray C, Henny K, Liau A, Willis L, et al. Efficacy of structural-level condom distribution interventions: a meta-analysis of U.S. and international studies, 1998–2007. AIDS Behav. 2011;15(7):1283–97.

    Article  PubMed  Google Scholar 

  45. Shannon J. What does SNAP benefit usage tell us about food access in low-income neighborhoods? Soc Sci Med. 2014;107:89–99.

    Article  PubMed  Google Scholar 

  46. Anderson RT, Yang TC, Matthews SA, Camacho F, Kern T, Mackley HB, et al. Breast cancer screening, area deprivation, and later-stage breast cancer in Appalachia: does geography matter? Health Serv Res. 2014;49(2):546–67.

    Article  PubMed  Google Scholar 

  47. Tan W, Stehman FB, Carter RL. Mortality rates due to gynecologic cancers in New York state by demographic factors and proximity to a Gynecologic Oncology Group member treatment center: 1979–2001. Gynecol Oncol. 2009;114(2):346–52.

    Article  PubMed  Google Scholar 

  48. Levy ME, Wilton L, Phillips G II, Glick SN, Kuo I, Brewer RA, et al. Understanding structural barriers to accessing HIV testing and prevention services among black men who have sex with men (BMSM) in the United States. AIDS Behav. 2014;18(5):972–96.

    Article  PubMed  PubMed Central  Google Scholar 

  49. Jones J, Salazar LF, Crosby R. Contextual factors and sexual risk behaviors among young, black men. Am J Mens Health. 2015.

  50. Espada JP, Morales A, Guillen-Riquelme A, Ballester R, Orgiles M. Predicting condom use in adolescents: a test of three socio-cognitive models using a structural equation modeling approach. BMC Public Health. 2016;16(1):35.

    Article  PubMed  PubMed Central  Google Scholar 

Download references

Acknowledgments

The authors would like to acknowledge the research participation of Courtney Brightharp, MPH; Max Holtz, MPH; Lauren Ho, MPH; and Elizabeth Baney, MPH and the departmental support for this study.

Author information

Authors and Affiliations

  1. 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

    Enbal Shacham, Lauren Schulte, Mark Bloomfield & Ryan Murphy

  2. Department of Epidemiology, College for Public Health and Social Justice, Saint Louis University, St. Louis, MO, 63104, USA

    Erik J Nelson

Authors
  1. Enbal Shacham
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Erik J Nelson
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Lauren Schulte
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Mark Bloomfield
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Ryan Murphy
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Enbal Shacham.

Ethics declarations

Conflict of interests

The authors have no conflicts of interests or financial disclosures to report.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Shacham, E., J Nelson, E., Schulte, L. et al. Geographic Variation in Condom Availability and Accessibility. AIDS Behav 20, 2863–2872 (2016). https://doi.org/10.1007/s10461-016-1383-0

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10461-016-1383-0

Keywords

Search

Navigation