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Throughout the Southern United States Community Based Organizations (CBOs) are continuing to work on HIV prevention and risk reduction strategies, all while following physical distancing guidelines and addressing the COVID-19 global pandemic. So, how can CBOs continue doing prevention activities, such as condom distribution, while physical distancing?

The following content provides innovative ideas and best practices for continuing condom distribution programs while remaining physically distant.

Based on the “3As” of a Condom Distribution program (Availability, Accessibility, and Acceptability), the following are some examples of barriers that an organization may face.

This discussion on the 3As is based on the original Condom Distribution as a Structural Intervention Institute disseminated by The Centers for Disease Control and Prevention.

Availability

Have CBOs been able to receive new stock during the COVID-19 response?

Towards the beginning of the pandemic, there were concerns on the limited manufacturing of condoms in Asian countries, where most condoms and materials needed for condoms are produced. This could have delayed large shipments to local health departments (LHDs), shortening their respective supplies and distribution capacity to CBOs.

This situation may show some fluctuation, as some industrial and transportation activities may progressively normalize.

While LHDs currently restock their supplies, it is recommended for CBOs to assess their current stock, not hoard condom supplies, meaning when LHDs do have more in stock, be mindful of the other CBOs in the area that may need condoms. 

Communicate with other CBOs about their stock balance, and keep the LHD informed, so they can make the most appropriate distribution.

Have there been delays in shipments?

Supply chain issues form only one part of the picture. Concerns about transmission of the new coronavirus has led to increased vigilance by oversight bodies, including around import, freight, and clearance of shipments, thus slowing down the shipment of condoms even further.

 A Condom Shortage Due to the Coronavirus Pandemic Might Happen—Here's What Experts Say You Should Do

Condoms and lubricants in the time of COVID-19

Challenges coordinating with a local health department for condom pick up?    

Assuming the LHD has condoms for pick up, a potential solution is for all of the local CBOs to arrange a specific date and time for condom pickups. One date and time can reduce the burden on LHDs and provide more of a structure for picking up condoms in the future. This pick up structure can help in reducing potential exposure during physical distancing. (See previous comment about fear distribution based on stock vs. demand as reported by each CBO.)

Accessibility

CBOs being closed due to the shelter in place policies in their jurisdiction?

Depending on where in the country a CBO is located, determine if they are currently open and serving the public.  (Demand of condoms may vary, now that distancing activities may either limit accessibility; or new approach activities like sending by mail, etc., may open new avenues for accessibility. CBOs should assess and/or estimate this variation and report to LHDs).

Partnering distribution sites closed?

Yes, the bars and clubs may be closed, but many essential services and entry points are still available. Perhaps partner with your local food pantry to distribute condoms there or with organizations distributing face masks, and other social aid.

Perhaps the STD clinic or PrEP clinics are open, placing condom dispensers with bags strategically around the clinic can make condoms more accessible, or make a goodie bag for individuals to take with them. If condoms are out of site, they may be out of mind.

Residential programs closing?

What type of agreements does the CBO have with rehabilitation programs? This could be an opportunity to send condoms to these programs for their residents, as residents may not be permitted to leave to get their own protection.

Acceptability

As Community Based Organizations in the South continue to navigate acceptable ways to distribute condoms while physically distancing, some questions may come up. Below are some things to consider along with some suggested best practices.

Are there ways to engage with individuals quarantining in non-affirming households?

Yes, there are many creative ways to engage with community, even while physical distancing.

An example of a best practice is the organization United Black Ellument, based in Dallas, TX. They have converted their social groups and drop-in center into a digital space through Zoom, allowing people to still participate in activities while feeling socially connected with affirming individuals.

Additionally, check out ways you can engage with individuals on our Social Marketing while Physical Distancing page.

Are there new resources available to sex positivity and “hooking up” during COVID-19?

In addition to condoms preventing HIV, STDs, and unplanned pregnancy, condoms also assist in reducing risk in contracting COVID-19. NASTAD and NCSD have collaborated on a Safe Sex and COVID-19: Frequently Asked Questions resource. Additionally, be sure to check out these infographics:

Sex and COVID-19: Partners Within Your Home

Sex and COVID-19: Partners Outside Your Home

Concern of confidentiality and trust in filling out condom request forms?

Many programs have already implemented condom delivery programs and can serve as a “best practice model” to reference.

DC Health Includes an easy to use order form, that includes an “acknowledgement” box that says, “I acknowledge that I am a resident of Washington, DC and that by submitting this form, I am permitting DC Health to mail me a package of free condoms and lubricant to my home address in an unmarked envelope.”

Hope and Help is a CBO in Central Florida that offers a subscription for condoms to be mailed to individuals that sign up, called “Protect Your O”. While Hope and Help’s service is for the Central Florida region, their form has the option for individuals to select which condoms they’d like and has privacy language that can serve as an example for other condom delivery programs.

“*Subscriber Statement

By clicking the box below, you agree to the following statement about your subscription.

I confirm that I am the person listed above and consent to participate in Protect Your 'O' by receiving a monthly supply of condoms mailed to the address I listed through USPS mail. I agree that it is my responsibility to notify Hope & Help at condoms@hopeandhelp.org to cancel my subscription at anytime. I agree to allow Hope & Help to contact me about my enrollment in Protect Your 'O'. I understand that Hope & Help may use my contact information to offer me additional services and programs, which I may opt-out at anytime by sending an email to Hope & Help at condoms@hopeandhelp.org. I also understand that Hope & Help will not sell my contact information to third parties.

I confirm that I am a resident of any of the following counties in the state of Florida: Orange, Osceola, Lake, Seminole, or Brevard.”

Community Assessment

Conduct a community assessment to assess additional barriers around the 3 A’s and population’s attitudes about condom distribution during COVID-19.

CBOs community assessment, things to consider:

  • Survey fatigue
    • Be mindful of making the survey easy to fill out, quick, and relevant.
    • Promote the survey online, on your email listserv, and through social media channels.
  • While this assessment does not cover the 3 A’s of condom distribution, it is a great example of collecting demographic information, is engaging, and is approachable.
  • Texas Department of State Health Services put together a presentation on designing a community assessment for condom distribution programs.
  • While not a live example, this mock sample assessment can help when you design a condom distribution assessment.
  • Pages 19-21 of these worksheets can also help when planning your community assessment.
  • Assess social marketing strategies, platforms and ads, preferences and utilization by priority populations. Check out ways you can assess your impact on our Social Marketing while Physical Distancing page.

Condom Economics

How to determine the cost and scale of your physical distancing condom distribution

  • Identifying costs for alternative distribution strategies:
    • For a mail subscription program, the following resources would be needed: Envelopes, cost to mail (depending on weight of package), condoms, lubricant, and people power to field condom mailing requests, email system to take request orders.
    • Creating digital ads about “to go condom kits”. Costs depend on:
      • the social media platform
      • the desired population to reach
      • length of time to “boost” a post.
    • Leverage current engagement strategies, including email blasts to the organization’s listserv
    • Partnering with community stakeholders to distribute condoms in their communities
  • Determine “condom connection” hubs, where community leaders/ neighborhood representatives pick up condoms for their respective communities

(Image of a box being given to a gate keeper, and their distribution to the community)

  • Identifying the scale of the condom distribution while physical distancing depends on the capacity of: (1) the community-based organization, (2) their current distribution plans, and (3) how they will modify their current condom distribution (CD) plans.
    • Cook county states how many condoms they will distribute in their order form.
    • Consider condom packets
      • How many to make and distribute?
      • How many lube and condom packets in each packet?
      • How many condom kits would be distributed to an individual?

For additional technical assistance on ordering or paying for condoms, NASTAD offers Technical Assistance and Capacity Building Activities to CDC funded Health Departments and CBOs in the South (request additional TA Here--- can link to CTS).

COVID-19 / Condom Distribution Implementation Plan

Define objectives, goals and measurements:

Why is this important?

Creating objectives, goals, and measurements at the beginning of a new program is a great way to track your program’s successes and impact! Having clear goals at the beginning will not only provide a game plan to follow, but can also significantly help when applying for grant funding in the future.

Tip: Funders LOVE to see “SMART” (Specific, Measurable, Achievable, Realistic, Time-bound) goals, objectives, and performance measurements. They love seeing numbers to show a program’s success. Not having numbers can greatly affect the success of future funding.

The following are examples of a SMART goal, objective, and measurement indicators.

  • Goal
    • Example: Reduce the number of new HIV transmissions among African American MSM youth at risk for acquiring HIV
  • Clear, SMART objectives
    • Example: By December 31, 2020, the Physical Distancing CD program will distribute 3000 condoms to Gate Keepers of African-American MSM to distribute in three high prevalence zip codes.
  • Measurement Indicators
    • Number of condoms distributed during new implementation plan
    • Number of agencies, venues, or settings where free condoms are distributed
    • Estimated number of audience impressions from campaign messages
    • Number of community gate keepers coordinated with
    • Number of boxes distributed in high prevalence zip codes

In addition to creating your goals, objectives, and measurements, a great way to put everything together is through a “logic model”. The logic model helps create a path to successfully reach the proposed goals and objectives and should be integrated in the ongoing organization plan. 

See the below, an example of a COVID-19 Condom Distribution Implementation Plan Logic Model.

Policies and Procedures of the new Condom Distribution while Physical Distancing Program: Are there current policies or procedures in your jurisdiction that advance or hinder condom distribution?

Think of what policies are currently in place, and what would need to change to facilitate an effective condom distribution program. NASTAD offers Technical Assistance and Capacity Building Activities to CDC funded Health Departments and CBOs in the South (request additional TA Here--- can link to CTS).