Farnaz Vahidnia | PubMed Health

PubMed2005

Revisiting community-based distribution programs: are they still needed?

Community-based distribution (CBD) programs are the optimum way of reaching people in rural areas of developing countries where conventional methods of delivery do not exist or fail. This paper reviews findings and experiences from over 30 years of efforts to implement CBD of family planning methods around the world. Although research suggests that community-based service delivery can contribute to contraceptive use, the magnitude of impact is often in doubt or its existence is questionable when compared to alternative family planning delivery services. After the review of more than 30 years of CBD work, we found that these programs are still needed to meet the needs for contraception in rural communities and isolated city neighborhoods in developing countries. Integration with other health outreach programs, effective management, keeping training of agents brief and letting them distribute contraceptives and keeping all or part of the profits instead of paying them salaries are some of the strategies that can make CBD programs more efficient.

Contraception↗

PubMed2005

Gender and relationship differences in condom use among 15-24-year-olds in Angola.

CONTEXT: The sexual behavior of young people in Angola will play a major role in the future spread of HIV, yet few young people use condoms consistently, and reported rates of condom use are low. It is important to identify determinants of condom use among Angolan adolescents and young adults. METHODS: Data for analysis came from 1,995 sexually experienced youth aged 15-24 who participated in a 2001 knowledge, attitudes and practices survey in Luanda, Angola. Logistic regression analysis was performed to identify predictors of consistent condom use by gender and determinants of condom use at last intercourse by type of relationship. RESULTS: For both males and females, consistent condom use was positively associated with higher levels of education (odds ratios, 1.7-2.6) and believing that condoms did not diminish sexual pleasure (1.8 for both genders). It was negatively associated with being married or in a cohabiting relationship (0.1-0.5). Females who equated condom use with lack of trust were less likely to use condoms consistently (0.5), and males who believed that condoms were safe and those who had multiple partners were more likely to be consistent users (1.6 and 1.7, respectively). Urban residence, higher education, being in school and not equating condom use with lack of trust were important predictors of use at last intercourse in regular and casual relationships, whereas access to condoms was the most important factor in spousal relationships (4.5). CONCLUSIONS: Intervention programs aimed at less educated, periurban and unemployed young people should be part of an effective HIV-prevention strategy. Such programs must address misperceptions among youth about condom use and the need for protection from HIV and other STIs.

Adolescent↗