4 Condom and Lubricant Programming
Condom distribution programmes should work with sex workers and clients to understand their preferences for condom products, including condom size, colour, scent and branding preferences. Distributing low-priced social marketing condoms in outlets close to sex work venues, in combination with free distribution of generic condoms through community outreach workers, is often the most effective way to ensure broad-based accessibility of condoms for sex workers and clients.
Wherever condoms are distributed, water- and silicone-based lubricants should also be made available according to the preferences of sex workers. All condom and lubricant products should meet WHO recommendations( see Section 4.4 for information on WHO recommendations for procurement of condom and lubricants). Lubricant distribution should accompany condom distribution, with lubricants made available in tubes, sachets or other packages according to sex workers’ preference. Social marketing organizations often package lubricants together with condoms, which can be an effective approach to lubricant distribution.
Box 4.1
Case example: Co-packaging of condoms and lubricant in Laos
In Laos, Population Services International distributed co-packaged condom and lubricant, branded as Number One Deluxe Plus. The co-packaged condom and lubricant was distributed by community outreach workers to sex workers, men who have sex with men and transgender individuals in conjunction with an informational brochure that emphasized that condoms and lubricants should be used together to prevent disease transmission and minimize condom breakage.
While lubricant distribution should accompany condom distribution, the primary focus should be on increasing condom use, and therefore product communications should focus on lubricant use in the presence of a condom. There is limited and inconclusive evidence that lubricant use in the absence of a condom may contribute to STI transmission; therefore, programmes should promote lubricants with condoms.
Beyond condoms and lubricants, sex workers often need access to additional protective products. Depending upon the local context and needs, sex workers may need access to dental dams and gloves for specific sexual services, soap and water and / or recommended cleaning products for cleaning sex toys, and other products, as identified by sex workers. Programmes working with sex workers require penis models for condom demonstrations and vaginal models for female condom demonstrations, and should incorporate these and other commodity needs identified above into their procurement planning and product distribution efforts.
4.2.2 Multi-level promotion of male and female condoms and lubricants
A condom promotion strategy for sex workers must be evidence-based. Prior to the development of the strategy, a situation analysis should be carried out, including descriptive data about sex workers, such as where they work and other factors that may help or hinder their ability to use condoms consistently and correctly with all sexual partners. The condom promotion strategy should also be informed by relevant behaviour-change theories and the experiences of behavioural interventions that have increased condom use between sex workers and their clients.
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