NYC Department of Health high school condom availability program: How many condoms are enough?

OBJECTIVE: The number of condoms needed or used by any population is not well documented. Our objective was to develop an evaluation standard for the Bronx District Public Health Office's (DPHO) school-based Condom Availability Program (CAP). CAP's aim is to increase condom distribution in an effort to reduce the teen pregnancy rate in the South Bronx (SBX).

PROCEDURE: We based our estimate on Meekers et al's formula that uses the product of three numbers to derive the number of condoms needed in a population: (1) percent sexually active, (2) the proportion using a condom at last sex and (3) the frequency of sex. While local Youth Risk Behavior Survey (YRBS) data provided statistics (1) and (2) no local data sources included frequency of sex. We substituted National Survey of Family Growth (NSFG) proportions adjusted to account for SBX sexual activity and included only male students to avoid double counting.

FINDINGS: An estimated 584,071 (or 65 per sexually active male) condoms are needed annually to protect every intercourse between teens in the SBX. School-specific CAP targets were also calculated. Our estimate provides a concrete target for CAP program leaders, enabling them to monitor the intervention's progress.

LIMITATIONS: Limitations of this methodology are: estimate does not adjust for lost/broken condoms, data used in calculations spans different years (2000 Census, 2002 NSFG, 2005 YRBS) and does not account for population growth and shifts in sexual behaviors. To improve our estimate, we have added frequency of sex question to the 2007 local YRBS.