Evaluation of a condom promotion program among Batey residents in the Dominican Republic, 2006-2008
B. Nieto-Andrade1, J. Hasbún2, C. Barrington3, L. Abreu4, A. Gottert3, C. Szymanski4, G. Agudelo4
1Population Services International, Guatemala, Guatemala, 2External Consultant, Santo Domingo, Dominican Republic, 3University of North Caroline, Gillings School of Global Public Health, Chapel Hill, United States, 4Population Services International, Santo Domingo, Dominican Republic
Background: PSI-Dominican Republic is conducting a condom promotion program in impoverished Haitian immigrant settlements (Bateyes) with higher HIV-prevalence (3.2%) than at the national level (0.8%)(DHS,2007). The program is based on collaboration with partner NGO's.
Methods: To evaluate the impact of its interventions, PSI conducted two cross-sectional behavioral surveys with 20-49 years old residents of Bateyes, using time-location sampling, in 2006(n=1,500) and 2008(n=1,487). Controlling for socio-demographics factors, Unianova Analysis was conducted to assess changes over time and programmatic impact. Values are reported using mean scores from likert scales (ranging from 1=totally disagree to 4=totally agree) or percentages.
Results: Between 2006-2008 condom use at last sex increased with casual partners from 81.0% to 93.6%, p< 0.001, and with commercial partners from 81.6% to 96.6%, p< 0.01. The increased condom use with commercial partners is attributable to PSI interventions: people exposed to PSI reported significantly higher levels of condom use than those non-exposed.The program also showed impact on: self-efficacy to use condoms (mean value changed from 3.07 to 3.19, p< 0.01); knowledge on correct use of condoms (2.87 to 3.12, p< 0.001); support from friends to talk about condom use (2.40 to 2.88, p< 0.001); social norms on having only one partner (1.98 to 2.80, p< 0.001); having condoms at home (1.73 to 2.37, p< 0.001); and having received free condoms last year (39.6% to 69.3%, p< 0.001).
Conclusions: Between 2006-2008 PSI's collaborative program with partner NGOs increased condom use at last sex with commercial partners among residents of Bateyes, as well as several other determinants of condom use. Given the high levels of condom use at last sex with casual and commercial partners in 2009 (over 90%), future interventions should emphasize maintaining that level and promoting consistent condom use with all partners, as well as determinants of condom use that could support sustainability of these changes.
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