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Condom promotion in sub-Saharan Africa has been accused by some conservative groups of encouraging promiscuity. This study explored the relationship between condom availability and sexually transmitted infection (STI) incidence in a closed Malawian community. An audit of clinic records charted the changing availability of condoms and the concurrent incidence of patients presenting with STI-associated urethral discharge (UD). When condoms first became available, their distribution steadily increased and the UD incidence declined. During a three-month period of unavailability, this previously uninterrupted decline was reversed and UD incidence increased. Once condoms again became available, UD incidence resumed its decline. This association was found to be statistically significant (Spearman's correlation coefficient, -0.499; P = 0.035). In a small community largely isolated from neighbouring towns, condom distribution appeared to negatively correlate with the number of patients presenting with UD. This may challenge the local belief that condoms have a damaging effect on sexual health in Malawi.

Original publication

DOI

10.1258/095646207781439801

Type

Journal article

Journal

International journal of STD & AIDS

Publication Date

08/2007

Volume

18

Pages

559 - 562

Addresses

Warwick Medical School, Cryfield 3, University of Warwick, Coventry, UK. d.metcalfe@warwick.ac.uk

Keywords

Humans, Sexually Transmitted Diseases, Urethral Diseases, Incidence, Retrospective Studies, Condoms, Safe Sex, Rural Population, Community Health Services, Malawi, Male