The evaluation of the Woman’s Condom marketing approach: What value did peer-led interpersonal communication add to the promotion of a new female condom in urban Lusaka?

Autoři: Jessie Pinchoff aff001;  Christopher B. Boyer aff002;  Rachna Nag Chowdhuri aff003;  Gina Smith aff004;  Namwinga Chintu aff004;  Thoai D. Ngo aff001
Působiště autorů: Population Council, New York, NY, United States of America aff001;  Innovations for Poverty Action, New York, NY, United States of America aff002;  Innovations for Poverty Action, Lusaka, Zambia aff003;  Society for Family Health, Lusaka, Zambia aff004
Vyšlo v časopise: PLoS ONE 14(12)
Kategorie: Research Article
doi: 10.1371/journal.pone.0225832


During a mass media campaign accompanying the launch of the Maximum Diva Woman’s Condom (WC) in Lusaka, Zambia, a cluster-randomized evaluation was implemented to measure the added impact of a peer-led interpersonal communication (IPC) intervention on the awareness and uptake of the new female condom (FC). The WC and mass media campaign were introduced simultaneously in 40 urban wards in April 2016; half of the wards were randomly assigned to the treatment (IPC intervention) with cross-sectional surveys conducted before (n = 2,364) and one year after (n = 2,430) the start of the intervention. A pre-specified intention-to-treat (ITT) analysis measured the impact of randomization to IPC at the community level. In adjusted ITT models, there were no statistically significant differences between intervention and control groups. Due to significant implementation challenges, we also conducted exploratory secondary analyses to estimate effects among those who attended an IPC event (n = 66) using instrumental variable and inverse probability weighting analyses. In addition to increases in FC identification (IPC attendees had higher reported use of any condom, improved perceptions of FC’s, and were more likely to have discussed contraceptive use with their partner as compared to non-attendees). The introduction of a new FC product combined with an IPC intervention significantly increased general knowledge and awareness in the community as compared to media alone, but did not lead to detectable community level impacts on other primary outcomes of interest. Observational evidence from our study suggests that IPC attendance is associated with increased use and negotiation. Future studies should explore the intensity and duration of IPC programming necessary to achieve detectable community level impacts on behavior.

Trial Registration: AEARCTR-0000899

Klíčová slova:

Behavior – Contraceptives – Female contraception – Male contraception – Marketing – Mass media – Social communication – Young adults


1. Institute G. Adding it up: investing in contraception and maternal and newborn health, 2017 Fact Sheet. New York, NY: Guttmacher Institute, 2017.

2. Gallo MF, Kilbourne-Brook M, Coffey PS. A review of the effectiveness and acceptability of the female condom for dual protection. Sexual Health. 2012;9(1):18–26. doi: 10.1071/SH11037 22348629

3. Ananga M, Kugbey N, Akporlu J, Asante K. Knowledge, acceptance and utilisation of the female condom among women of reproductive age in Ghana. Contraception Reprod Med. 2017;2(15).

4. Moore L, Beksinska M, Rumphs A, Festin M, Gollub E. Knowledge, Attitudes, practices and behaviors associated with female condoms in developing countries: A scoping review. Journal of Contraception. 2015;6:125–42.

5. Mvundura M, Nundy N, Kilbourne-Brook M, Coffey P. Estimating the hypothetical dual health impact and cost-effectiveness of the Woman’s Condom in selected sub-Saharan African countries. International Journal of Women's Health. 2015;7:271–7. doi: 10.2147/IJWH.S75040 25784820

6. Welsh M, Feldblum P, Kuyoh M, Mwarogo P, Kungu D. Condom use during a community intervention trial in Kenya. International Journao of STDs and AIDS. 2001;12(7):469–74.

7. Adeokun L, Mantell J, Weiss E, Delano G, Jagha T, Olatoregun J, et al. Promoting Dual Protection in Family Planning Clinics In Ibadan Nigeria. International Family Planning Perspectives. 2002;28(2):87–95.

8. PATH U. Female Condom: A Powerful Tool for Protection. Seattle: UNFPA, PATH, 2006.

9. Fontanet A, Saba J, Chandelying V, Sakondhavat C, Bhiraleus P, Rugpao S, et al. Protection against sexually transmitted diseases by granting sex workers in Thailand the choice of using the male or female condom: results from a randomized controlled trial. AIDS Behavior. 1998;12(14):1851–9.

10. Ministry of Health aII. Zambia Demographic and Health Survey 2013–14. Rockville, Maryland, USA: Central Statistical Office.: Central Statistical Office (CSO) [Zambia], Ministry of Health (MOH) [Zambia], and ICF International., 2014.

11. Meekers D, Richter K. Factors associated with use of the female condom in Zimbabwe. International Family Planning Perspectives. 2005;31(1):30–7. doi: 10.1363/3103005 15888407

12. Schwartz JL, Barnhart K, Creinin MD, Poindexter A, Wheeless A, Kilbourne-Brook M, et al. Comparative crossover study of the PATH Woman's Condom and the FC Female Condom. Contraception. 2008;78(6):465–73. doi: 10.1016/j.contraception.2008.07.020 19014792

13. Beksinska M, Smit J, Mabude Z, Vijayakumar G, Linda J. Male partner involvement and assistance in female condom use. European J of Contraception and Reproductive Healthcare. 2008;13(4):400–3.

14. Free C, Roberts I, Abramsky T, Fitzgerald M, Wensley F. A systematic review of randomised controlled trials of interventions promoting effective condom use. J Epidemiol Community Health. 2011;65:100–10. doi: 10.1136/jech.2008.085456 19822557

15. Devanter NV, Gonzales V, Merzel C, Parikh N, Celantano D, Greenberg J. EFfect of an STD/HIV behavioral intervention on women's use of the female condom. American Journal of Public Health. 2002;92(1):109–15. doi: 10.2105/ajph.92.1.109 11772772

16. Friedman A, Kachur R, Noar S, McFarlane M. Health Communication and Social Marketing Campaigns for Sexually Transmitted Disease Prevention and Control: What Is the Evidence of their Effectiveness? Sexually Transmitted Diseases. 2016;43(2S):S83–S101.

17. Martin J, Lora Pd, Rochat R, Andes K. Understanding female condom use and negotiation among young women in Cape Town, South Africa. International Perspectives on Sexual and Reproductive Health. 2016;42(1):13–20. doi: 10.1363/42e0216 28825912

18. Hansen B, Bowers J. Covariate balance in simple, stratified and clustered comparative studies. Statistical Science. 2008;23(2):219–36.

19. Pinchoff J, Chowdhuri R, Taruberekera N, Ngo T. Impact of communication strategies to increase knowledge, acceptability and uptake of a new Woman's Condom in urban Lusaka, Zambia: study protocol for a randomized controlled trial. BMC Trials. 2016;17. doi: 10.1186/s13063-016-1681-x 27964747

20. Cleland J. Illustrative Questionnaire for Interview-Surveys with Young People. Geneva, Switzerland: World Health Organization.

21. Little R, Rubin D. Causal Effects in Clinical and Epidemiological Studies Via Potential Outcomes: Concepts and Analytical Approaches. Annual Review of Public Health. 2000;21:121–45. doi: 10.1146/annurev.publhealth.21.1.121 10884949

22. Jo B, Stuart E. On the use of propensity scores in principal causal effect estimation. Stat Med. 2009;28(23):2857–75. doi: 10.1002/sim.3669 19610131

23. Chattu VK. How best can we plan & implement HIV prevention? A review of successful evidence based practices & research. International Journal of Medical Research & Health Sciences. 2014;3(3):700–9.

24. Choi K-H, Gregorich SE. Social Network Influences on Male and Female Condom Use among Women Attending Family Planning Clinics in the U.S. Sexually transmitted diseases. 2009;36(12):757–62. doi: 10.1097/OLQ.0b013e3181afefc1 PMC2787869. 19704396

25. Appiah A, Tenkorang E, Maticka-Tyndale E. Modeling beliefs, attitudes and intentions of condom use among secondary school students in Kenya. Arch Sex Behav. 2017.

26. Campbell A, Tross S, Hu M, Pavlicova M, Kenney J, Nunes E. Female condom skill and attitude: results from a NIDA Clinical Trials Network gender-specific HIV risk reduction study. AIDS Educ Prev. 2011;23(4):329–40. doi: 10.1521/aeap.2011.23.4.329 21861607

27. Tumlinson K, Speizer I, Davis J, Fotso J, Kuria P, Archer L. Partner communication, discordant fertility goals, and contraceptive use in urban Kenya. African Journal of Reproductive Health. 2014;17(3):79–90.

Článek vyšel v časopise


2019 Číslo 12