UNFPAState of World Population 2003
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State of World Population
Overview of Adolescent Life
Gender Inequality and Reproductive Health
HIV/AIDS and Adolescents
Promoting Healthier Behavior
Meeting Reproductive Health Services Needs
Comprehensive Programmes for Adolescents
Giving Priority to Adolescents
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HIV/AIDS and Adolescents

Contributing Factors
Regional Differences
Impact of AIDS on Young People
Social Marketing of Contraceptives
Services for HIV/AIDS Prevention and Care

Social Marketing of Contraceptives

The “ABC” approach, Abstinence, Be faithful, and use Condoms (as detailed in Chapter 4) has proven effective. Social marketing combines market research and advertising techniques with health promotion through mass media, peer promoters and community-based events. Condoms are usually the product that is marketed, often with a “dual protection” message to help protect against both pregnancy and STIs including HIV. Nearly any place where young people spend time and congregate, from school to work to discos, is a potential site for information provision and condom availability.

Social marketing, like mass media, can be targeted to specific groups. In Indonesia, a successful campaign to increase condom use among commercial sex workers combined print media, events at bars and universities, counselling on condom negotiation and education of brothel owners. As a result, the percentage of sex workers using condoms increased from 36 to 48.(32)

The Social Marketing for Adolescent Sexual Health (SMASH) programme, carried out by Population Services International, evaluated activities in urban areas of Botswana, Cameroon, Guinea and South Africa. Initiatives used schools, mass media, youth clubs and peer interventions to raise awareness and promote safer sex practices, especially condom use, among young people.

While these activities succeeded in raising awareness of the benefits of protective behaviour including abstinence and condom use, and in reducing the barriers to condom use, they were less successful in changing behaviour. It had more success among young women than among young men, suggesting that the two groups need to be reached in different ways.(33)


The SMASH assessment of condom social marketing activities aimed at young people in four African countries found that:

  • Changing adolescent behaviour may require intensive efforts lasting at least two to three years.
  • Programmes are most effective if they include a carefully designed mix of mass media promotion and face-to-face communication.
  • Young men and women have different sexual health concerns that need to be addressed differently.
  • Careful communication strategies are needed to reduce the stigma associated with condom use.
  • Youth should be involved in programme design.
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Building on lessons learned from the SMASH programme in Cameroon, another social marketing programme was initiated there in 2000. The first phase used a mass-media campaign, radio call-in shows, a newspaper, peer educators and a radio drama to promote consistent condom use, particularly with regular partners. Activities in the current phase encourage parents to talk to their children about HIV/AIDS prevention, empower girls to negotiate abstinence or condom use, and emphasize the importance of using condoms consistently with regular partners.(34)

There are many negative and often mistaken attitudes about condom use. Some young people do not believe the condom offers reliable protection against unwanted pregnancy or even HIV. In a study in Kenya, only 35 per cent of urban students and 56 per cent of rural students expressed confidence in the effectiveness of condoms.(35) A study in Botswana found that 76 per cent of boys were convinced that condoms often slide off.(36) Another study in Botswana indicated that some youth believe condoms spread infection.(37) Negative perceptions about the condom were also found to be a major obstacle in prevention activities in Suriname.(38)

Young men in a focus group discussion in South Africa said they did not have the courage to ask for condoms in pharmacies and clinics. They said pharmacy or clinic staff expressed displeasure at the sexual activity of young people. The young men said they would like to be able to get condoms in game arcades, public toilets, nightclubs, music shops, internet cafes and vending machines—and from their peers rather than from adults. Some also expressed discomfort using condoms due to inexperience, and seemed more worried about maintaining their image than about the risks of unprotected sex.(39)

Despite these drawbacks, an evaluation concluded that, “Social marketing approaches directed at youth appear to hold significant promise for promoting condom use on a relatively large scale and for making regular condom use socially acceptable. Media efforts should be combined with pharmacies and other private-sector outlets that young people prefer for reasons of confidentiality and convenience, and should be combined with training to make these services more youth friendly.”(40)

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