Background: Condom use is a very effective HIV/STI prevention strategy, yet usage remains low. In Sub-Saharan Africa, standard condoms are available at health facilities, but uptake is low and community members perceive their quality to be inferior compared to branded condoms. HPTN071(PopART) is a 3-arm community-randomized trial of a combination HIV prevention package in 21 communities in Zambia and South Africa. The intervention includes condom distribution delivered door-to-door by community health workers. Our objective was to understand condom preferences of participants in 8 intervention communities in Zambia.
Methods: Standard government-provided male (Giulin Zizhu Latex Co Ltd) and female (fc2®) condoms were provided to participants from December 2013-September 2017. Alternative branded condoms (Moods®) and lubricants (Optilube®) were provided from June 2015-September 2017. Electronic data on numbers of condoms requested and received during household visits, and condom preferences were collected from 8 intervention communities in Zambia from July 2016-August 2017, and analysed using STATA 13.1. Semi-structured interviews were conducted to find participants'' preferred type of condom, and reason for the preference.
Results: Overall, 292,552 people consented to participate in the main PopART intervention, 97.8% had data recorded. Excluding those < 15 years, 165,873 participants remained: 37.5% male, 62.5% female (Figure 1). Of the males, 7% requested and received lubricant, 6.7% female condoms, and 32% male condoms (branded and government). Of men receiving condoms, 65.6% expressed interest in receiving branded condoms compared to 17.2% in those who didn''t receive condoms. For females, 6.5% requested and received lubricant, 7.5% female condoms and 18.6% male condoms (branded and government). Of women receiving male condoms 63.6% expressed interest in receiving more branded condoms compared to 10.7% who didn''t receive condoms. Overall, flavoured and scented condoms were the most preferred across all age groups because they “felt like skin to skin”; were “light and strong”; and “had a good smell.” More women (20.4%) than men (7.4%) self-reported preference in receiving female condoms.
Conclusions: Future programs and governments should consider adding flavoured, scented and female condoms to encourage condom use. Research should be conducted on whether receiving branded male condoms and lubricant has an impact on condom usage among community members.

  Total N(%)Flavoured N(%)Scented N(%)Ribbed N(%)Studded N(%)Female N(%)Other brand-specific type N(%)
Age categories15-2467, 23910,333(15.4)6,428(9.6)3,080(4.6)2,869(4.3)1,991 (3.0)303(0.5)
 25-3447, 09810,052(21.3)6,176(13.1)3,044(6.5)2,820(6.0)2,118(4.5)294(0.6)
 35-4426, 2445,165(19.7)3,220(12.3)1,554(5.9)1,447(5.5)1,176(4.5)155(0.6)
 >4525, 2922,245(8.9)1,378(5.5)671(2.7)663(2.6)466(1.8)76(0.3)
[Table 1: Community condom preferences disaggregated by age in Zambia]

Figure 1: Flow chart of community condom preferences disaggregated by gender in Zambia
[Figure 1: Flow chart of community condom preferences disaggregated by gender in Zambia]

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